Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TRAY SINGLE SHOT EPIDL 182A050

Facility

$109.75

Hospital Charge Code	270632601
Hospital Revenue Code	272
Min. Negotiated Rate	$16.46
Max. Negotiated Rate	$16.46
Rate for Payer: Qualcare PPO/HMO/WC	$16.46

TRAY SINGLE SHOT EPIDL 182A050

Facility

$109.75

Hospital Charge Code	270632601
Hospital Revenue Code	272
Min. Negotiated Rate	$2.64
Max. Negotiated Rate	$54.88
Rate for Payer: Aetna Commercial	$41.70
Rate for Payer: Aetna Medicare Advantage	$32.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.99
Rate for Payer: Cigna Commercial	$54.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.92
Rate for Payer: Oxford Commercial	$21.95
Rate for Payer: Qualcare PPO/HMO/WC	$16.46
Rate for Payer: UnitedHealthcare Commercial	$21.95
Rate for Payer: UnitedHealthcare Community & State	$2.64
Rate for Payer: Wellpoint Medicaid Managed Care	$2.91

TRAY SINGLE SHOT EPIDURAL 20G

Facility

$84.77

Hospital Charge Code	270655731
Hospital Revenue Code	272
Min. Negotiated Rate	$2.04
Max. Negotiated Rate	$42.38
Rate for Payer: Aetna Commercial	$32.21
Rate for Payer: Aetna Medicare Advantage	$25.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.62
Rate for Payer: Cigna Commercial	$42.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.43
Rate for Payer: Oxford Commercial	$16.95
Rate for Payer: Qualcare PPO/HMO/WC	$12.72
Rate for Payer: UnitedHealthcare Commercial	$16.95
Rate for Payer: UnitedHealthcare Community & State	$2.04
Rate for Payer: Wellpoint Medicaid Managed Care	$2.25

TRAY SINGLE SHOT EPIDURAL 20G

Facility

$84.77

Hospital Charge Code	270655731
Hospital Revenue Code	272
Min. Negotiated Rate	$12.72
Max. Negotiated Rate	$12.72
Rate for Payer: Qualcare PPO/HMO/WC	$12.72

TRAY SKIN PREP 4480

Facility

$18.89

Hospital Charge Code	270613962
Hospital Revenue Code	272
Min. Negotiated Rate	$2.83
Max. Negotiated Rate	$2.83
Rate for Payer: Qualcare PPO/HMO/WC	$2.83

TRAY SKIN PREP 4480

Facility

$18.89

Hospital Charge Code	270613962
Hospital Revenue Code	272
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$9.45
Rate for Payer: Aetna Commercial	$7.18
Rate for Payer: Aetna Medicare Advantage	$5.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.82
Rate for Payer: Cigna Commercial	$9.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.67
Rate for Payer: Oxford Commercial	$3.78
Rate for Payer: Qualcare PPO/HMO/WC	$2.83
Rate for Payer: UnitedHealthcare Commercial	$3.78
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.50

TRAY SKIN SCRUB WET

Facility

$19.31

Hospital Charge Code	270649184
Hospital Revenue Code	272
Min. Negotiated Rate	$2.90
Max. Negotiated Rate	$2.90
Rate for Payer: Qualcare PPO/HMO/WC	$2.90

TRAY SKIN SCRUB WET

Facility

$19.31

Hospital Charge Code	270649184
Hospital Revenue Code	272
Min. Negotiated Rate	$0.47
Max. Negotiated Rate	$9.65
Rate for Payer: Aetna Commercial	$7.34
Rate for Payer: Aetna Medicare Advantage	$5.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.92
Rate for Payer: Cigna Commercial	$9.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.79
Rate for Payer: Oxford Commercial	$3.86
Rate for Payer: Qualcare PPO/HMO/WC	$2.90
Rate for Payer: UnitedHealthcare Commercial	$3.86
Rate for Payer: UnitedHealthcare Community & State	$0.47
Rate for Payer: Wellpoint Medicaid Managed Care	$0.51

TRAY SOFT TISSUE BX

Facility

$43.95

Hospital Charge Code	270677166N
Hospital Revenue Code	272
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$21.98
Rate for Payer: Aetna Commercial	$16.70
Rate for Payer: Aetna Medicare Advantage	$13.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.21
Rate for Payer: Cigna Commercial	$21.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.19
Rate for Payer: Oxford Commercial	$8.79
Rate for Payer: Qualcare PPO/HMO/WC	$6.59
Rate for Payer: UnitedHealthcare Commercial	$8.79
Rate for Payer: UnitedHealthcare Community & State	$1.06
Rate for Payer: Wellpoint Medicaid Managed Care	$1.16

TRAY SOFT TISSUE BX

Facility

$43.99

Hospital Charge Code	270677166R
Hospital Revenue Code	272
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

TRAY SOFT TISSUE BX

Facility

$43.99

Hospital Charge Code	270677166R
Hospital Revenue Code	272
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$22.00
Rate for Payer: Aetna Commercial	$16.72
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.20
Rate for Payer: Oxford Commercial	$8.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$8.80
Rate for Payer: UnitedHealthcare Community & State	$1.06
Rate for Payer: Wellpoint Medicaid Managed Care	$1.17

TRAY SOFT TISSUE BX

Facility

$43.99

Hospital Charge Code	270677166
Hospital Revenue Code	272
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

TRAY SOFT TISSUE BX

Facility

$43.99

Hospital Charge Code	270677166
Hospital Revenue Code	272
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$22.00
Rate for Payer: Aetna Commercial	$16.72
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.20
Rate for Payer: Oxford Commercial	$8.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$8.80
Rate for Payer: UnitedHealthcare Community & State	$1.06
Rate for Payer: Wellpoint Medicaid Managed Care	$1.17

TRAY SOFT TISSUE BX

Facility

$43.95

Hospital Charge Code	270677166N
Hospital Revenue Code	272
Min. Negotiated Rate	$6.59
Max. Negotiated Rate	$6.59
Rate for Payer: Qualcare PPO/HMO/WC	$6.59

TRAY SPINAL *******

Facility

$230.00

Hospital Charge Code	8002339
Hospital Revenue Code	279
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$34.50
Rate for Payer: Qualcare PPO/HMO/WC	$34.50

TRAY SPINAL *******

Facility

$230.00

Hospital Charge Code	8002339
Hospital Revenue Code	279
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$115.00
Rate for Payer: Aetna Commercial	$87.40
Rate for Payer: Aetna Medicare Advantage	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.65
Rate for Payer: Cigna Commercial	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.00
Rate for Payer: Oxford Commercial	$46.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.50
Rate for Payer: UnitedHealthcare Commercial	$46.00
Rate for Payer: UnitedHealthcare Community & State	$5.54
Rate for Payer: Wellpoint Medicaid Managed Care	$6.09

TRAY SPINAL ANESTHESIA

Facility

$113.65

Hospital Charge Code	270070095
Hospital Revenue Code	272
Min. Negotiated Rate	$2.74
Max. Negotiated Rate	$56.83
Rate for Payer: Aetna Commercial	$43.19
Rate for Payer: Aetna Medicare Advantage	$34.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.98
Rate for Payer: Cigna Commercial	$56.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.09
Rate for Payer: Oxford Commercial	$22.73
Rate for Payer: Qualcare PPO/HMO/WC	$17.05
Rate for Payer: UnitedHealthcare Commercial	$22.73
Rate for Payer: UnitedHealthcare Community & State	$2.74
Rate for Payer: Wellpoint Medicaid Managed Care	$3.01

TRAY SPINAL ANESTHESIA

Facility

$113.65

Hospital Charge Code	270070095
Hospital Revenue Code	272
Min. Negotiated Rate	$17.05
Max. Negotiated Rate	$17.05
Rate for Payer: Qualcare PPO/HMO/WC	$17.05

TRAY SPINAL ANESTHESIA

Facility

$65.89

Hospital Charge Code	270649897
Hospital Revenue Code	272
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$32.95
Rate for Payer: Aetna Commercial	$25.04
Rate for Payer: Aetna Medicare Advantage	$19.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.80
Rate for Payer: Cigna Commercial	$32.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.77
Rate for Payer: Oxford Commercial	$13.18
Rate for Payer: Qualcare PPO/HMO/WC	$9.88
Rate for Payer: UnitedHealthcare Commercial	$13.18
Rate for Payer: UnitedHealthcare Community & State	$1.59
Rate for Payer: Wellpoint Medicaid Managed Care	$1.75

TRAY SPINAL ANESTHESIA

Facility

$65.89

Hospital Charge Code	270649897
Hospital Revenue Code	272
Min. Negotiated Rate	$9.88
Max. Negotiated Rate	$9.88
Rate for Payer: Qualcare PPO/HMO/WC	$9.88

TRAY SPINAL ANESTHESIA ****

Facility

$61.00

Hospital Charge Code	1800135
Hospital Revenue Code	279
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$30.50
Rate for Payer: Aetna Commercial	$23.18
Rate for Payer: Aetna Medicare Advantage	$18.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.55
Rate for Payer: Cigna Commercial	$30.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.30
Rate for Payer: Oxford Commercial	$12.20
Rate for Payer: Qualcare PPO/HMO/WC	$9.15
Rate for Payer: UnitedHealthcare Commercial	$12.20
Rate for Payer: UnitedHealthcare Community & State	$1.47
Rate for Payer: Wellpoint Medicaid Managed Care	$1.62

TRAY SPINAL ANESTHESIA ****

Facility

$61.00

Hospital Charge Code	1800135
Hospital Revenue Code	279
Min. Negotiated Rate	$9.15
Max. Negotiated Rate	$9.15
Rate for Payer: Qualcare PPO/HMO/WC	$9.15

TRAY SPINAL ANESTHESIA *****

Facility

$43.00

Hospital Charge Code	1603091
Hospital Revenue Code	279
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$16.34
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.90
Rate for Payer: Oxford Commercial	$8.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$8.60
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.14

TRAY SPINAL ANESTHESIA *****

Facility

$43.00

Hospital Charge Code	1603091
Hospital Revenue Code	279
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

TRAY SPINAL PENCAN 24GAX4IN

Facility

$91.77

Service Code	HCPCS A4649
Hospital Charge Code	270698870
Hospital Revenue Code	270
Min. Negotiated Rate	$2.21
Max. Negotiated Rate	$45.88
Rate for Payer: Aetna Commercial	$34.87
Rate for Payer: Aetna Medicare Advantage	$27.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.40
Rate for Payer: Cigna Commercial	$45.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.53
Rate for Payer: Oxford Commercial	$18.35
Rate for Payer: Qualcare PPO/HMO/WC	$13.77
Rate for Payer: UnitedHealthcare Commercial	$18.35
Rate for Payer: UnitedHealthcare Community & State	$2.21
Rate for Payer: Wellpoint Medicaid Managed Care	$2.43

Know your out-of-pocket cost for care.

All Charges