Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TRAY SUTURE REMOVAL SET

Facility

$3.40

Hospital Charge Code	270649272
Hospital Revenue Code	270
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$0.51
Rate for Payer: Qualcare PPO/HMO/WC	$0.51

TRAY SUTURE REMOVAL SET

Facility

$3.40

Hospital Charge Code	270649272
Hospital Revenue Code	270
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$1.70
Rate for Payer: Aetna Commercial	$1.29
Rate for Payer: Aetna Medicare Advantage	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.87
Rate for Payer: Cigna Commercial	$1.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.02
Rate for Payer: Oxford Commercial	$0.68
Rate for Payer: Qualcare PPO/HMO/WC	$0.51
Rate for Payer: UnitedHealthcare Commercial	$0.68
Rate for Payer: UnitedHealthcare Community & State	$0.08
Rate for Payer: Wellpoint Medicaid Managed Care	$0.09

TRAY T/A

Facility

$190.36

Hospital Charge Code	270654144
Hospital Revenue Code	270
Min. Negotiated Rate	$28.55
Max. Negotiated Rate	$28.55
Rate for Payer: Qualcare PPO/HMO/WC	$28.55

TRAY T/A

Facility

$190.36

Hospital Charge Code	270654144
Hospital Revenue Code	270
Min. Negotiated Rate	$4.59
Max. Negotiated Rate	$95.18
Rate for Payer: Aetna Commercial	$72.34
Rate for Payer: Aetna Medicare Advantage	$57.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.54
Rate for Payer: Cigna Commercial	$95.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.11
Rate for Payer: Oxford Commercial	$38.07
Rate for Payer: Qualcare PPO/HMO/WC	$28.55
Rate for Payer: UnitedHealthcare Commercial	$38.07
Rate for Payer: UnitedHealthcare Community & State	$4.59
Rate for Payer: Wellpoint Medicaid Managed Care	$5.04

TRAY TBIAL MD SZ A LEFT 154718

Facility

$7,715.00

Hospital Charge Code	270639275
Hospital Revenue Code	272
Min. Negotiated Rate	$1,157.25
Max. Negotiated Rate	$1,157.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,157.25

TRAY TBIAL MD SZ A LEFT 154718

Facility

$7,715.00

Hospital Charge Code	270639275
Hospital Revenue Code	272
Min. Negotiated Rate	$185.93
Max. Negotiated Rate	$3,857.50
Rate for Payer: Aetna Commercial	$2,931.70
Rate for Payer: Aetna Medicare Advantage	$2,314.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,967.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,967.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,967.33
Rate for Payer: Cigna Commercial	$3,857.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,314.50
Rate for Payer: Oxford Commercial	$1,543.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,157.25
Rate for Payer: UnitedHealthcare Commercial	$1,543.00
Rate for Payer: UnitedHealthcare Community & State	$185.93
Rate for Payer: Wellpoint Medicaid Managed Care	$204.45

TRAY THAL-QUICK CHEST TUBE 8FR

Facility

$755.95

Hospital Charge Code	270677080
Hospital Revenue Code	272
Min. Negotiated Rate	$18.22
Max. Negotiated Rate	$377.98
Rate for Payer: Aetna Commercial	$287.26
Rate for Payer: Aetna Medicare Advantage	$226.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.77
Rate for Payer: Cigna Commercial	$377.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.78
Rate for Payer: Oxford Commercial	$151.19
Rate for Payer: Qualcare PPO/HMO/WC	$113.39
Rate for Payer: UnitedHealthcare Commercial	$151.19
Rate for Payer: UnitedHealthcare Community & State	$18.22
Rate for Payer: Wellpoint Medicaid Managed Care	$20.03

TRAY THAL-QUICK CHEST TUBE 8FR

Facility

$755.95

Hospital Charge Code	270677080
Hospital Revenue Code	272
Min. Negotiated Rate	$113.39
Max. Negotiated Rate	$113.39
Rate for Payer: Qualcare PPO/HMO/WC	$113.39

TRAY THORACENTESIS

Facility

$115.56

Hospital Charge Code	270303235
Hospital Revenue Code	272
Min. Negotiated Rate	$2.78
Max. Negotiated Rate	$57.78
Rate for Payer: Aetna Commercial	$43.91
Rate for Payer: Aetna Medicare Advantage	$34.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.47
Rate for Payer: Cigna Commercial	$57.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.67
Rate for Payer: Oxford Commercial	$23.11
Rate for Payer: Qualcare PPO/HMO/WC	$17.33
Rate for Payer: UnitedHealthcare Commercial	$23.11
Rate for Payer: UnitedHealthcare Community & State	$2.78
Rate for Payer: Wellpoint Medicaid Managed Care	$3.06

TRAY THORACENTESIS

Facility

$115.56

Hospital Charge Code	270303235
Hospital Revenue Code	272
Min. Negotiated Rate	$17.33
Max. Negotiated Rate	$17.33
Rate for Payer: Qualcare PPO/HMO/WC	$17.33

TRAY THORACENTESIS 48/CS

Facility

$14.25

Hospital Charge Code	270649810
Hospital Revenue Code	271
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$7.12
Rate for Payer: Aetna Commercial	$5.42
Rate for Payer: Aetna Medicare Advantage	$4.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.63
Rate for Payer: Cigna Commercial	$7.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.28
Rate for Payer: Oxford Commercial	$2.85
Rate for Payer: Qualcare PPO/HMO/WC	$2.14
Rate for Payer: UnitedHealthcare Commercial	$2.85
Rate for Payer: UnitedHealthcare Community & State	$0.34
Rate for Payer: Wellpoint Medicaid Managed Care	$0.38

TRAY THORACENTESIS 48/CS

Facility

$14.25

Hospital Charge Code	270649810
Hospital Revenue Code	271
Min. Negotiated Rate	$2.14
Max. Negotiated Rate	$2.14
Rate for Payer: Qualcare PPO/HMO/WC	$2.14

TRAY THORACENTESIS W/ASP NEEDL

Facility

$2,519.75

Hospital Charge Code	270650921
Hospital Revenue Code	278
Min. Negotiated Rate	$377.96
Max. Negotiated Rate	$609.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$503.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$609.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$554.35
Rate for Payer: Qualcare PPO/HMO/WC	$377.96

TRAY THORACENTESIS W/ASP NEEDL

Facility

$2,519.75

Hospital Charge Code	270650921
Hospital Revenue Code	278
Min. Negotiated Rate	$60.73
Max. Negotiated Rate	$1,259.88
Rate for Payer: Aetna Commercial	$957.50
Rate for Payer: Aetna Medicare Advantage	$755.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$642.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$642.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$503.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$642.54
Rate for Payer: Cigna Commercial	$1,259.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$609.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$554.35
Rate for Payer: Qualcare PPO/HMO/WC	$377.96
Rate for Payer: UnitedHealthcare Community & State	$60.73
Rate for Payer: Wellpoint Medicaid Managed Care	$66.77

TRAY THORACENTESIS W/ASP NEEDL

Facility

$197.75

Hospital Charge Code	270653354
Hospital Revenue Code	270
Min. Negotiated Rate	$4.77
Max. Negotiated Rate	$98.88
Rate for Payer: Aetna Commercial	$75.14
Rate for Payer: Aetna Medicare Advantage	$59.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.43
Rate for Payer: Cigna Commercial	$98.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.33
Rate for Payer: Oxford Commercial	$39.55
Rate for Payer: Qualcare PPO/HMO/WC	$29.66
Rate for Payer: UnitedHealthcare Commercial	$39.55
Rate for Payer: UnitedHealthcare Community & State	$4.77
Rate for Payer: Wellpoint Medicaid Managed Care	$5.24

TRAY THORACENTESIS W/ASP NEEDL

Facility

$197.75

Hospital Charge Code	270653354
Hospital Revenue Code	270
Min. Negotiated Rate	$29.66
Max. Negotiated Rate	$29.66
Rate for Payer: Qualcare PPO/HMO/WC	$29.66

TRAY THORACENTESIS W/CATH

Facility

$179.25

Hospital Charge Code	270303240
Hospital Revenue Code	272
Min. Negotiated Rate	$4.32
Max. Negotiated Rate	$89.62
Rate for Payer: Aetna Commercial	$68.11
Rate for Payer: Aetna Medicare Advantage	$53.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.71
Rate for Payer: Cigna Commercial	$89.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.77
Rate for Payer: Oxford Commercial	$35.85
Rate for Payer: Qualcare PPO/HMO/WC	$26.89
Rate for Payer: UnitedHealthcare Commercial	$35.85
Rate for Payer: UnitedHealthcare Community & State	$4.32
Rate for Payer: Wellpoint Medicaid Managed Care	$4.75

TRAY THORACENTESIS W/CATH

Facility

$179.25

Hospital Charge Code	270303240
Hospital Revenue Code	272
Min. Negotiated Rate	$26.89
Max. Negotiated Rate	$26.89
Rate for Payer: Qualcare PPO/HMO/WC	$26.89

TRAY THORACENTESIS W/O CATH***

Facility

$84.00

Hospital Charge Code	8004459
Hospital Revenue Code	279
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$42.00
Rate for Payer: Aetna Commercial	$31.92
Rate for Payer: Aetna Medicare Advantage	$25.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.42
Rate for Payer: Cigna Commercial	$42.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.20
Rate for Payer: Oxford Commercial	$16.80
Rate for Payer: Qualcare PPO/HMO/WC	$12.60
Rate for Payer: UnitedHealthcare Commercial	$16.80
Rate for Payer: UnitedHealthcare Community & State	$2.02
Rate for Payer: Wellpoint Medicaid Managed Care	$2.23

TRAY THORACENTESIS W/O CATH***

Facility

$84.00

Hospital Charge Code	8004459
Hospital Revenue Code	279
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.60

TRAY THORACOTOMY *******

Facility

$253.00

Hospital Charge Code	8002412
Hospital Revenue Code	279
Min. Negotiated Rate	$37.95
Max. Negotiated Rate	$37.95
Rate for Payer: Qualcare PPO/HMO/WC	$37.95

TRAY THORACOTOMY *******

Facility

$253.00

Hospital Charge Code	8002412
Hospital Revenue Code	279
Min. Negotiated Rate	$6.10
Max. Negotiated Rate	$126.50
Rate for Payer: Aetna Commercial	$96.14
Rate for Payer: Aetna Medicare Advantage	$75.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.52
Rate for Payer: Cigna Commercial	$126.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.90
Rate for Payer: Oxford Commercial	$50.60
Rate for Payer: Qualcare PPO/HMO/WC	$37.95
Rate for Payer: UnitedHealthcare Commercial	$50.60
Rate for Payer: UnitedHealthcare Community & State	$6.10
Rate for Payer: Wellpoint Medicaid Managed Care	$6.70

TRAY THORANCENTESIS****

Facility

$271.00

Hospital Charge Code	8002388
Hospital Revenue Code	279
Min. Negotiated Rate	$6.53
Max. Negotiated Rate	$135.50
Rate for Payer: Aetna Commercial	$102.98
Rate for Payer: Aetna Medicare Advantage	$81.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.11
Rate for Payer: Cigna Commercial	$135.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.30
Rate for Payer: Oxford Commercial	$54.20
Rate for Payer: Qualcare PPO/HMO/WC	$40.65
Rate for Payer: UnitedHealthcare Commercial	$54.20
Rate for Payer: UnitedHealthcare Community & State	$6.53
Rate for Payer: Wellpoint Medicaid Managed Care	$7.18

TRAY THORANCENTESIS****

Facility

$271.00

Hospital Charge Code	8002388
Hospital Revenue Code	279
Min. Negotiated Rate	$40.65
Max. Negotiated Rate	$40.65
Rate for Payer: Qualcare PPO/HMO/WC	$40.65

TRAY THORANCENTESIS W/CATH***

Facility

$64.00

Hospital Charge Code	8003287
Hospital Revenue Code	279
Min. Negotiated Rate	$9.60
Max. Negotiated Rate	$9.60
Rate for Payer: Qualcare PPO/HMO/WC	$9.60

Know your out-of-pocket cost for care.

All Charges