Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TRAY PONSKI PULL PEG 20F 00330

Facility

$607.25

Hospital Charge Code	270616766
Hospital Revenue Code	272
Min. Negotiated Rate	$91.09
Max. Negotiated Rate	$91.09
Rate for Payer: Qualcare PPO/HMO/WC	$91.09

TRAY POWER TRIALYSIS CATH15

Facility

$1,050.00

Hospital Charge Code	270664145
Hospital Revenue Code	272
Min. Negotiated Rate	$25.30
Max. Negotiated Rate	$525.00
Rate for Payer: Aetna Commercial	$399.00
Rate for Payer: Aetna Medicare Advantage	$315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.75
Rate for Payer: Cigna Commercial	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$315.00
Rate for Payer: Oxford Commercial	$210.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.50
Rate for Payer: UnitedHealthcare Commercial	$210.00
Rate for Payer: UnitedHealthcare Community & State	$25.30
Rate for Payer: Wellpoint Medicaid Managed Care	$27.82

TRAY POWER TRIALYSIS CATH15

Facility

$1,050.00

Hospital Charge Code	270664145
Hospital Revenue Code	272
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$157.50
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

TRAY POWER TRIALYSIS CATH20

Facility

$1,068.95

Hospital Charge Code	270664146
Hospital Revenue Code	272
Min. Negotiated Rate	$160.34
Max. Negotiated Rate	$160.34
Rate for Payer: Qualcare PPO/HMO/WC	$160.34

TRAY POWER TRIALYSIS CATH20

Facility

$1,068.95

Hospital Charge Code	270664146
Hospital Revenue Code	272
Min. Negotiated Rate	$25.76
Max. Negotiated Rate	$534.48
Rate for Payer: Aetna Commercial	$406.20
Rate for Payer: Aetna Medicare Advantage	$320.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.58
Rate for Payer: Cigna Commercial	$534.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.69
Rate for Payer: Oxford Commercial	$213.79
Rate for Payer: Qualcare PPO/HMO/WC	$160.34
Rate for Payer: UnitedHealthcare Commercial	$213.79
Rate for Payer: UnitedHealthcare Community & State	$25.76
Rate for Payer: Wellpoint Medicaid Managed Care	$28.33

TRAY PREOPERATIVE SKIN PREP

Facility

$16.44

Hospital Charge Code	270620052
Hospital Revenue Code	272
Min. Negotiated Rate	$0.40
Max. Negotiated Rate	$8.22
Rate for Payer: Aetna Commercial	$6.25
Rate for Payer: Aetna Medicare Advantage	$4.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.19
Rate for Payer: Cigna Commercial	$8.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.93
Rate for Payer: Oxford Commercial	$3.29
Rate for Payer: Qualcare PPO/HMO/WC	$2.47
Rate for Payer: UnitedHealthcare Commercial	$3.29
Rate for Payer: UnitedHealthcare Community & State	$0.40
Rate for Payer: Wellpoint Medicaid Managed Care	$0.44

TRAY PREOPERATIVE SKIN PREP

Facility

$16.44

Hospital Charge Code	270620052
Hospital Revenue Code	272
Min. Negotiated Rate	$2.47
Max. Negotiated Rate	$2.47
Rate for Payer: Qualcare PPO/HMO/WC	$2.47

TRAY PREOPERATIVE SKIN PREP

Facility

$16.44

Hospital Charge Code	70620052
Hospital Revenue Code	272
Min. Negotiated Rate	$2.47
Max. Negotiated Rate	$2.47
Rate for Payer: Qualcare PPO/HMO/WC	$2.47

TRAY PREOPERATIVE SKIN PREP

Facility

$16.44

Hospital Charge Code	70620052
Hospital Revenue Code	272
Min. Negotiated Rate	$0.40
Max. Negotiated Rate	$8.22
Rate for Payer: Aetna Commercial	$6.25
Rate for Payer: Aetna Medicare Advantage	$4.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.19
Rate for Payer: Cigna Commercial	$8.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.93
Rate for Payer: Oxford Commercial	$3.29
Rate for Payer: Qualcare PPO/HMO/WC	$2.47
Rate for Payer: UnitedHealthcare Commercial	$3.29
Rate for Payer: UnitedHealthcare Community & State	$0.40
Rate for Payer: Wellpoint Medicaid Managed Care	$0.44

TRAY PREP

Facility

$9.65

Hospital Charge Code	270302250
Hospital Revenue Code	272
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.45

TRAY PREP

Facility

$9.65

Hospital Charge Code	270302250
Hospital Revenue Code	272
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$4.83
Rate for Payer: Aetna Commercial	$3.67
Rate for Payer: Aetna Medicare Advantage	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.46
Rate for Payer: Cigna Commercial	$4.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.90
Rate for Payer: Oxford Commercial	$1.93
Rate for Payer: Qualcare PPO/HMO/WC	$1.45
Rate for Payer: UnitedHealthcare Commercial	$1.93
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

TRAY PREP *********

Facility

$28.00

Hospital Charge Code	8001208
Hospital Revenue Code	279
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$14.00
Rate for Payer: Aetna Commercial	$10.64
Rate for Payer: Aetna Medicare Advantage	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.14
Rate for Payer: Cigna Commercial	$14.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.40
Rate for Payer: Oxford Commercial	$5.60
Rate for Payer: Qualcare PPO/HMO/WC	$4.20
Rate for Payer: UnitedHealthcare Commercial	$5.60
Rate for Payer: UnitedHealthcare Community & State	$0.67
Rate for Payer: Wellpoint Medicaid Managed Care	$0.74

TRAY PREP *********

Facility

$28.00

Hospital Charge Code	8001208
Hospital Revenue Code	279
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

TRAY RENTAL SHOULDER REPAIR

Facility

$500.00

Hospital Charge Code	270637784
Hospital Revenue Code	272
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

TRAY RENTAL SHOULDER REPAIR

Facility

$500.00

Hospital Charge Code	270637784
Hospital Revenue Code	272
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.00
Rate for Payer: Oxford Commercial	$100.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$100.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

TRAY ROBOTIC PACK

Facility

$565.90

Hospital Charge Code	270664963
Hospital Revenue Code	270
Min. Negotiated Rate	$84.89
Max. Negotiated Rate	$84.89
Rate for Payer: Qualcare PPO/HMO/WC	$84.89

TRAY ROBOTIC PACK

Facility

$565.90

Hospital Charge Code	270664963
Hospital Revenue Code	270
Min. Negotiated Rate	$13.64
Max. Negotiated Rate	$282.95
Rate for Payer: Aetna Commercial	$215.04
Rate for Payer: Aetna Medicare Advantage	$169.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.30
Rate for Payer: Cigna Commercial	$282.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.77
Rate for Payer: Oxford Commercial	$113.18
Rate for Payer: Qualcare PPO/HMO/WC	$84.89
Rate for Payer: UnitedHealthcare Commercial	$113.18
Rate for Payer: UnitedHealthcare Community & State	$13.64
Rate for Payer: Wellpoint Medicaid Managed Care	$15.00

TRAY SAFETY-T-CENTESIS 16FR

Facility

$294.40

Hospital Charge Code	270649763
Hospital Revenue Code	270
Min. Negotiated Rate	$7.10
Max. Negotiated Rate	$147.20
Rate for Payer: Aetna Commercial	$111.87
Rate for Payer: Aetna Medicare Advantage	$88.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.07
Rate for Payer: Cigna Commercial	$147.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.32
Rate for Payer: Oxford Commercial	$58.88
Rate for Payer: Qualcare PPO/HMO/WC	$44.16
Rate for Payer: UnitedHealthcare Commercial	$58.88
Rate for Payer: UnitedHealthcare Community & State	$7.10
Rate for Payer: Wellpoint Medicaid Managed Care	$7.80

TRAY SAFETY-T-CENTESIS 16FR

Facility

$294.40

Hospital Charge Code	270649763
Hospital Revenue Code	270
Min. Negotiated Rate	$44.16
Max. Negotiated Rate	$44.16
Rate for Payer: Qualcare PPO/HMO/WC	$44.16

TRAY SHOULDER ARTHROSCOPY

Facility

$465.75

Hospital Charge Code	270654121
Hospital Revenue Code	272
Min. Negotiated Rate	$69.86
Max. Negotiated Rate	$69.86
Rate for Payer: Qualcare PPO/HMO/WC	$69.86

TRAY SHOULDER ARTHROSCOPY

Facility

$465.75

Hospital Charge Code	270654121
Hospital Revenue Code	272
Min. Negotiated Rate	$11.22
Max. Negotiated Rate	$232.88
Rate for Payer: Aetna Commercial	$176.99
Rate for Payer: Aetna Medicare Advantage	$139.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$118.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$118.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$118.77
Rate for Payer: Cigna Commercial	$232.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.72
Rate for Payer: Oxford Commercial	$93.15
Rate for Payer: Qualcare PPO/HMO/WC	$69.86
Rate for Payer: UnitedHealthcare Commercial	$93.15
Rate for Payer: UnitedHealthcare Community & State	$11.22
Rate for Payer: Wellpoint Medicaid Managed Care	$12.34

TRAY SHOULDER REPAIR RENTAL

Facility

$496.00

Hospital Charge Code	270636065
Hospital Revenue Code	272
Min. Negotiated Rate	$74.40
Max. Negotiated Rate	$74.40
Rate for Payer: Qualcare PPO/HMO/WC	$74.40

TRAY SHOULDER REPAIR RENTAL

Facility

$496.00

Hospital Charge Code	270636065
Hospital Revenue Code	272
Min. Negotiated Rate	$11.95
Max. Negotiated Rate	$248.00
Rate for Payer: Aetna Commercial	$188.48
Rate for Payer: Aetna Medicare Advantage	$148.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.48
Rate for Payer: Cigna Commercial	$248.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.80
Rate for Payer: Oxford Commercial	$99.20
Rate for Payer: Qualcare PPO/HMO/WC	$74.40
Rate for Payer: UnitedHealthcare Commercial	$99.20
Rate for Payer: UnitedHealthcare Community & State	$11.95
Rate for Payer: Wellpoint Medicaid Managed Care	$13.14

TRAY SINGLE LUM W/ARROW

Facility

$138.00

Hospital Charge Code	270302220
Hospital Revenue Code	272
Min. Negotiated Rate	$20.70
Max. Negotiated Rate	$20.70
Rate for Payer: Qualcare PPO/HMO/WC	$20.70

TRAY SINGLE LUM W/ARROW

Facility

$138.00

Hospital Charge Code	270302220
Hospital Revenue Code	272
Min. Negotiated Rate	$3.33
Max. Negotiated Rate	$69.00
Rate for Payer: Aetna Commercial	$52.44
Rate for Payer: Aetna Medicare Advantage	$41.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.19
Rate for Payer: Cigna Commercial	$69.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.40
Rate for Payer: Oxford Commercial	$27.60
Rate for Payer: Qualcare PPO/HMO/WC	$20.70
Rate for Payer: UnitedHealthcare Commercial	$27.60
Rate for Payer: UnitedHealthcare Community & State	$3.33
Rate for Payer: Wellpoint Medicaid Managed Care	$3.66

Know your out-of-pocket cost for care.

All Charges