Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TRAY PARACENTESIS

Facility

$305.75

Hospital Charge Code	270650090
Hospital Revenue Code	271
Min. Negotiated Rate	$45.86
Max. Negotiated Rate	$45.86
Rate for Payer: Qualcare PPO/HMO/WC	$45.86

TRAY PARACENTESIS****

Facility

$141.00

Hospital Charge Code	8003261
Hospital Revenue Code	279
Min. Negotiated Rate	$21.15
Max. Negotiated Rate	$21.15
Rate for Payer: Qualcare PPO/HMO/WC	$21.15

TRAY PARACENTESIS****

Facility

$141.00

Hospital Charge Code	8003261
Hospital Revenue Code	279
Min. Negotiated Rate	$3.40
Max. Negotiated Rate	$70.50
Rate for Payer: Aetna Commercial	$53.58
Rate for Payer: Aetna Medicare Advantage	$42.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.95
Rate for Payer: Cigna Commercial	$70.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.30
Rate for Payer: Oxford Commercial	$28.20
Rate for Payer: Qualcare PPO/HMO/WC	$21.15
Rate for Payer: UnitedHealthcare Commercial	$28.20
Rate for Payer: UnitedHealthcare Community & State	$3.40
Rate for Payer: Wellpoint Medicaid Managed Care	$3.74

TRAY PASPORT ELITE 21-4591

Facility

$2,415.60

Hospital Charge Code	270630573
Hospital Revenue Code	272
Min. Negotiated Rate	$362.34
Max. Negotiated Rate	$362.34
Rate for Payer: Qualcare PPO/HMO/WC	$362.34

TRAY PASPORT ELITE 21-4591

Facility

$2,415.60

Hospital Charge Code	270630573
Hospital Revenue Code	272
Min. Negotiated Rate	$58.22
Max. Negotiated Rate	$1,207.80
Rate for Payer: Aetna Commercial	$917.93
Rate for Payer: Aetna Medicare Advantage	$724.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$615.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$615.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$615.98
Rate for Payer: Cigna Commercial	$1,207.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$724.68
Rate for Payer: Oxford Commercial	$483.12
Rate for Payer: Qualcare PPO/HMO/WC	$362.34
Rate for Payer: UnitedHealthcare Commercial	$483.12
Rate for Payer: UnitedHealthcare Community & State	$58.22
Rate for Payer: Wellpoint Medicaid Managed Care	$64.01

TRAY PASSING HANDS FR 252244V

Facility

$10.14

Hospital Charge Code	270629845
Hospital Revenue Code	272
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$5.07
Rate for Payer: Aetna Commercial	$3.85
Rate for Payer: Aetna Medicare Advantage	$3.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.59
Rate for Payer: Cigna Commercial	$5.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.04
Rate for Payer: Oxford Commercial	$2.03
Rate for Payer: Qualcare PPO/HMO/WC	$1.52
Rate for Payer: UnitedHealthcare Commercial	$2.03
Rate for Payer: UnitedHealthcare Community & State	$0.24
Rate for Payer: Wellpoint Medicaid Managed Care	$0.27

TRAY PASSING HANDS FR 252244V

Facility

$10.14

Hospital Charge Code	270629845
Hospital Revenue Code	272
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$1.52
Rate for Payer: Qualcare PPO/HMO/WC	$1.52

TRAY PELVIC

Facility

$75.00

Hospital Charge Code	8001224
Hospital Revenue Code	279
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.50
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$15.00
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

TRAY PELVIC

Facility

$75.00

Hospital Charge Code	8001224
Hospital Revenue Code	279
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

TRAY PELVIC EXAM SMALL

Facility

$16.59

Hospital Charge Code	270638654
Hospital Revenue Code	270
Min. Negotiated Rate	$2.49
Max. Negotiated Rate	$2.49
Rate for Payer: Qualcare PPO/HMO/WC	$2.49

TRAY PELVIC EXAM SMALL

Facility

$16.59

Hospital Charge Code	270638654
Hospital Revenue Code	270
Min. Negotiated Rate	$0.40
Max. Negotiated Rate	$8.29
Rate for Payer: Aetna Commercial	$6.30
Rate for Payer: Aetna Medicare Advantage	$4.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.23
Rate for Payer: Cigna Commercial	$8.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.98
Rate for Payer: Oxford Commercial	$3.32
Rate for Payer: Qualcare PPO/HMO/WC	$2.49
Rate for Payer: UnitedHealthcare Commercial	$3.32
Rate for Payer: UnitedHealthcare Community & State	$0.40
Rate for Payer: Wellpoint Medicaid Managed Care	$0.44

TRAY PELVIC NON-DISP

Facility

$192.85

Hospital Charge Code	2708001224
Hospital Revenue Code	272
Min. Negotiated Rate	$4.65
Max. Negotiated Rate	$96.42
Rate for Payer: Aetna Commercial	$73.28
Rate for Payer: Aetna Medicare Advantage	$57.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.18
Rate for Payer: Cigna Commercial	$96.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.85
Rate for Payer: Oxford Commercial	$38.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.93
Rate for Payer: UnitedHealthcare Commercial	$38.57
Rate for Payer: UnitedHealthcare Community & State	$4.65
Rate for Payer: Wellpoint Medicaid Managed Care	$5.11

TRAY PELVIC NON-DISP

Facility

$192.85

Hospital Charge Code	2708001224
Hospital Revenue Code	272
Min. Negotiated Rate	$28.93
Max. Negotiated Rate	$28.93
Rate for Payer: Qualcare PPO/HMO/WC	$28.93

TRAY PELVIX EXAM 8E7390

Facility

$27.25

Hospital Charge Code	270622672
Hospital Revenue Code	272
Min. Negotiated Rate	$0.66
Max. Negotiated Rate	$13.62
Rate for Payer: Aetna Commercial	$10.36
Rate for Payer: Aetna Medicare Advantage	$8.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.95
Rate for Payer: Cigna Commercial	$13.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.18
Rate for Payer: Oxford Commercial	$5.45
Rate for Payer: Qualcare PPO/HMO/WC	$4.09
Rate for Payer: UnitedHealthcare Commercial	$5.45
Rate for Payer: UnitedHealthcare Community & State	$0.66
Rate for Payer: Wellpoint Medicaid Managed Care	$0.72

TRAY PELVIX EXAM 8E7390

Facility

$27.25

Hospital Charge Code	270622672
Hospital Revenue Code	272
Min. Negotiated Rate	$4.09
Max. Negotiated Rate	$4.09
Rate for Payer: Qualcare PPO/HMO/WC	$4.09

TRAY PERC S DIL 8.0 W SUCTION

Facility

$1,709.25

Hospital Charge Code	270689359
Hospital Revenue Code	272
Min. Negotiated Rate	$256.39
Max. Negotiated Rate	$256.39
Rate for Payer: Qualcare PPO/HMO/WC	$256.39

TRAY PERC S DIL 8.0 W SUCTION

Facility

$1,709.25

Hospital Charge Code	270689359
Hospital Revenue Code	272
Min. Negotiated Rate	$41.19
Max. Negotiated Rate	$854.62
Rate for Payer: Aetna Commercial	$649.51
Rate for Payer: Aetna Medicare Advantage	$512.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$435.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$435.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$435.86
Rate for Payer: Cigna Commercial	$854.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$512.77
Rate for Payer: Oxford Commercial	$341.85
Rate for Payer: Qualcare PPO/HMO/WC	$256.39
Rate for Payer: UnitedHealthcare Commercial	$341.85
Rate for Payer: UnitedHealthcare Community & State	$41.19
Rate for Payer: Wellpoint Medicaid Managed Care	$45.30

TRAY PERCU-SET BIOPSY 43825A

Facility

$73.43

Hospital Charge Code	270605455
Hospital Revenue Code	270
Min. Negotiated Rate	$11.01
Max. Negotiated Rate	$11.01
Rate for Payer: Qualcare PPO/HMO/WC	$11.01

TRAY PERCU-SET BIOPSY 43825A

Facility

$73.43

Hospital Charge Code	270605455
Hospital Revenue Code	270
Min. Negotiated Rate	$1.77
Max. Negotiated Rate	$36.72
Rate for Payer: Aetna Commercial	$27.90
Rate for Payer: Aetna Medicare Advantage	$22.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.72
Rate for Payer: Cigna Commercial	$36.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.03
Rate for Payer: Oxford Commercial	$14.69
Rate for Payer: Qualcare PPO/HMO/WC	$11.01
Rate for Payer: UnitedHealthcare Commercial	$14.69
Rate for Payer: UnitedHealthcare Community & State	$1.77
Rate for Payer: Wellpoint Medicaid Managed Care	$1.95

TRAY PERCUTANEOUS INTROD 9FR

Facility

$271.27

Hospital Charge Code	270644536
Hospital Revenue Code	272
Min. Negotiated Rate	$40.69
Max. Negotiated Rate	$40.69
Rate for Payer: Qualcare PPO/HMO/WC	$40.69

TRAY PERCUTANEOUS INTROD 9FR

Facility

$271.27

Hospital Charge Code	270644536
Hospital Revenue Code	272
Min. Negotiated Rate	$6.54
Max. Negotiated Rate	$135.63
Rate for Payer: Aetna Commercial	$103.08
Rate for Payer: Aetna Medicare Advantage	$81.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.17
Rate for Payer: Cigna Commercial	$135.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.38
Rate for Payer: Oxford Commercial	$54.25
Rate for Payer: Qualcare PPO/HMO/WC	$40.69
Rate for Payer: UnitedHealthcare Commercial	$54.25
Rate for Payer: UnitedHealthcare Community & State	$6.54
Rate for Payer: Wellpoint Medicaid Managed Care	$7.19

TRAY PERCUTANEOUS S DIL 7.0

Facility

$1,678.75

Hospital Charge Code	270690630
Hospital Revenue Code	272
Min. Negotiated Rate	$40.46
Max. Negotiated Rate	$839.38
Rate for Payer: Aetna Commercial	$637.92
Rate for Payer: Aetna Medicare Advantage	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$428.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$428.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$428.08
Rate for Payer: Cigna Commercial	$839.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$503.62
Rate for Payer: Oxford Commercial	$335.75
Rate for Payer: Qualcare PPO/HMO/WC	$251.81
Rate for Payer: UnitedHealthcare Commercial	$335.75
Rate for Payer: UnitedHealthcare Community & State	$40.46
Rate for Payer: Wellpoint Medicaid Managed Care	$44.49

TRAY PERCUTANEOUS S DIL 7.0

Facility

$1,678.75

Hospital Charge Code	270690630
Hospital Revenue Code	272
Min. Negotiated Rate	$251.81
Max. Negotiated Rate	$251.81
Rate for Payer: Qualcare PPO/HMO/WC	$251.81

TRAY PERCUTANEOUS S DIL 8.0

Facility

$1,678.75

Hospital Charge Code	270689357
Hospital Revenue Code	272
Min. Negotiated Rate	$40.46
Max. Negotiated Rate	$839.38
Rate for Payer: Aetna Commercial	$637.92
Rate for Payer: Aetna Medicare Advantage	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$428.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$428.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$428.08
Rate for Payer: Cigna Commercial	$839.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$503.62
Rate for Payer: Oxford Commercial	$335.75
Rate for Payer: Qualcare PPO/HMO/WC	$251.81
Rate for Payer: UnitedHealthcare Commercial	$335.75
Rate for Payer: UnitedHealthcare Community & State	$40.46
Rate for Payer: Wellpoint Medicaid Managed Care	$44.49

TRAY PERCUTANEOUS S DIL 8.0

Facility

$1,678.75

Hospital Charge Code	270689357
Hospital Revenue Code	272
Min. Negotiated Rate	$251.81
Max. Negotiated Rate	$251.81
Rate for Payer: Qualcare PPO/HMO/WC	$251.81

Know your out-of-pocket cost for care.

All Charges