Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TRAY TPN CO #0769 *******

Facility

$40.00

Hospital Charge Code	8002917
Hospital Revenue Code	279
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

TRAY TRACH

Facility

$757.65

Hospital Charge Code	270805001
Hospital Revenue Code	270
Min. Negotiated Rate	$18.26
Max. Negotiated Rate	$378.82
Rate for Payer: Aetna Commercial	$287.91
Rate for Payer: Aetna Medicare Advantage	$227.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$193.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$193.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$193.20
Rate for Payer: Cigna Commercial	$378.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.29
Rate for Payer: Oxford Commercial	$151.53
Rate for Payer: Qualcare PPO/HMO/WC	$113.65
Rate for Payer: UnitedHealthcare Commercial	$151.53
Rate for Payer: UnitedHealthcare Community & State	$18.26
Rate for Payer: Wellpoint Medicaid Managed Care	$20.08

TRAY TRACH

Facility

$757.65

Hospital Charge Code	270805001
Hospital Revenue Code	270
Min. Negotiated Rate	$113.65
Max. Negotiated Rate	$113.65
Rate for Payer: Qualcare PPO/HMO/WC	$113.65

TRAY TRACH CATH DRESSG

Facility

$10.29

Hospital Charge Code	270110140
Hospital Revenue Code	272
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$5.14
Rate for Payer: Aetna Commercial	$3.91
Rate for Payer: Aetna Medicare Advantage	$3.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.62
Rate for Payer: Cigna Commercial	$5.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.09
Rate for Payer: Oxford Commercial	$2.06
Rate for Payer: Qualcare PPO/HMO/WC	$1.54
Rate for Payer: UnitedHealthcare Commercial	$2.06
Rate for Payer: UnitedHealthcare Community & State	$0.25
Rate for Payer: Wellpoint Medicaid Managed Care	$0.27

TRAY TRACH CATH DRESSG

Facility

$10.29

Hospital Charge Code	270110140
Hospital Revenue Code	272
Min. Negotiated Rate	$1.54
Max. Negotiated Rate	$1.54
Rate for Payer: Qualcare PPO/HMO/WC	$1.54

TRAY TRACHEOSTOMY CLEANING

Facility

$8.75

Hospital Charge Code	270649789
Hospital Revenue Code	270
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$4.38
Rate for Payer: Aetna Commercial	$3.33
Rate for Payer: Aetna Medicare Advantage	$2.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.23
Rate for Payer: Cigna Commercial	$4.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.62
Rate for Payer: Oxford Commercial	$1.75
Rate for Payer: Qualcare PPO/HMO/WC	$1.31
Rate for Payer: UnitedHealthcare Commercial	$1.75
Rate for Payer: UnitedHealthcare Community & State	$0.21
Rate for Payer: Wellpoint Medicaid Managed Care	$0.23

TRAY TRACHEOSTOMY CLEANING

Facility

$8.75

Hospital Charge Code	270649789
Hospital Revenue Code	270
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$1.31
Rate for Payer: Qualcare PPO/HMO/WC	$1.31

TRAY TRANSPARENT C.V.C

Facility

$15.30

Hospital Charge Code	270649273
Hospital Revenue Code	272
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$7.65
Rate for Payer: Aetna Commercial	$5.81
Rate for Payer: Aetna Medicare Advantage	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.90
Rate for Payer: Cigna Commercial	$7.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.59
Rate for Payer: Oxford Commercial	$3.06
Rate for Payer: Qualcare PPO/HMO/WC	$2.29
Rate for Payer: UnitedHealthcare Commercial	$3.06
Rate for Payer: UnitedHealthcare Community & State	$0.37
Rate for Payer: Wellpoint Medicaid Managed Care	$0.41

TRAY TRANSPARENT C.V.C

Facility

$15.30

Hospital Charge Code	270649273
Hospital Revenue Code	272
Min. Negotiated Rate	$2.29
Max. Negotiated Rate	$2.29
Rate for Payer: Qualcare PPO/HMO/WC	$2.29

TRAY TRIO CT BASIC SET 15CM

Facility

$700.00

Hospital Charge Code	270689090
Hospital Revenue Code	272
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

TRAY TRIO CT BASIC SET 15CM

Facility

$700.00

Hospital Charge Code	270689090
Hospital Revenue Code	272
Min. Negotiated Rate	$16.87
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$210.00
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Commercial	$140.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$18.55

TRAY TRIPLE LEMEN MULTI 7FR

Facility

$642.75

Hospital Charge Code	270665276
Hospital Revenue Code	272
Min. Negotiated Rate	$96.41
Max. Negotiated Rate	$96.41
Rate for Payer: Qualcare PPO/HMO/WC	$96.41

TRAY TRIPLE LEMEN MULTI 7FR

Facility

$642.75

Hospital Charge Code	270665276
Hospital Revenue Code	272
Min. Negotiated Rate	$15.49
Max. Negotiated Rate	$321.38
Rate for Payer: Aetna Commercial	$244.25
Rate for Payer: Aetna Medicare Advantage	$192.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$163.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$163.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$163.90
Rate for Payer: Cigna Commercial	$321.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.82
Rate for Payer: Oxford Commercial	$128.55
Rate for Payer: Qualcare PPO/HMO/WC	$96.41
Rate for Payer: UnitedHealthcare Commercial	$128.55
Rate for Payer: UnitedHealthcare Community & State	$15.49
Rate for Payer: Wellpoint Medicaid Managed Care	$17.03

TRAY TRIPLE LUM CATH AK25703A

Facility

$642.75

Service Code	HCPCS C1751
Hospital Charge Code	270302270
Hospital Revenue Code	278
Min. Negotiated Rate	$15.49
Max. Negotiated Rate	$321.38
Rate for Payer: Aetna Commercial	$244.25
Rate for Payer: Aetna Medicare Advantage	$192.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$163.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$163.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$163.90
Rate for Payer: Cigna Commercial	$321.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$141.41
Rate for Payer: Qualcare PPO/HMO/WC	$96.41
Rate for Payer: UnitedHealthcare Community & State	$15.49
Rate for Payer: Wellpoint Medicaid Managed Care	$17.03

TRAY TRIPLE LUM CATH AK25703A

Facility

$642.75

Service Code	HCPCS C1751
Hospital Charge Code	270302270
Hospital Revenue Code	278
Min. Negotiated Rate	$96.41
Max. Negotiated Rate	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$141.41
Rate for Payer: Qualcare PPO/HMO/WC	$96.41

TRAY TROCATH ADULT *******

Facility

$234.00

Hospital Charge Code	7000391
Hospital Revenue Code	279
Min. Negotiated Rate	$5.64
Max. Negotiated Rate	$117.00
Rate for Payer: Aetna Commercial	$88.92
Rate for Payer: Aetna Medicare Advantage	$70.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.67
Rate for Payer: Cigna Commercial	$117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.20
Rate for Payer: Oxford Commercial	$46.80
Rate for Payer: Qualcare PPO/HMO/WC	$35.10
Rate for Payer: UnitedHealthcare Commercial	$46.80
Rate for Payer: UnitedHealthcare Community & State	$5.64
Rate for Payer: Wellpoint Medicaid Managed Care	$6.20

TRAY TROCATH ADULT *******

Facility

$234.00

Hospital Charge Code	7000391
Hospital Revenue Code	279
Min. Negotiated Rate	$35.10
Max. Negotiated Rate	$35.10
Rate for Payer: Qualcare PPO/HMO/WC	$35.10

TRAY TSR SHOULDER REV 0MM OFFS

Facility

$17,420.00

Service Code	HCPCS C1776
Hospital Charge Code	270697092
Hospital Revenue Code	278
Min. Negotiated Rate	$419.82
Max. Negotiated Rate	$8,710.00
Rate for Payer: Aetna Commercial	$6,619.60
Rate for Payer: Aetna Medicare Advantage	$5,226.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,442.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,442.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,442.10
Rate for Payer: Cigna Commercial	$8,710.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,215.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,832.40
Rate for Payer: Qualcare PPO/HMO/WC	$2,613.00
Rate for Payer: UnitedHealthcare Community & State	$419.82
Rate for Payer: Wellpoint Medicaid Managed Care	$461.63

TRAY TSR SHOULDER REV 0MM OFFS

Facility

$17,420.00

Service Code	HCPCS C1776
Hospital Charge Code	270697092
Hospital Revenue Code	278
Min. Negotiated Rate	$2,613.00
Max. Negotiated Rate	$4,215.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,484.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,215.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,832.40
Rate for Payer: Qualcare PPO/HMO/WC	$2,613.00

TRAY UMBILICAL VESSEL 3.5/5FR

Facility

$312.69

Hospital Charge Code	270649899
Hospital Revenue Code	272
Min. Negotiated Rate	$7.54
Max. Negotiated Rate	$156.34
Rate for Payer: Aetna Commercial	$118.82
Rate for Payer: Aetna Medicare Advantage	$93.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.74
Rate for Payer: Cigna Commercial	$156.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.81
Rate for Payer: Oxford Commercial	$62.54
Rate for Payer: Qualcare PPO/HMO/WC	$46.90
Rate for Payer: UnitedHealthcare Commercial	$62.54
Rate for Payer: UnitedHealthcare Community & State	$7.54
Rate for Payer: Wellpoint Medicaid Managed Care	$8.29

TRAY UMBILICAL VESSEL 3.5/5FR

Facility

$312.69

Hospital Charge Code	270649899
Hospital Revenue Code	272
Min. Negotiated Rate	$46.90
Max. Negotiated Rate	$46.90
Rate for Payer: Qualcare PPO/HMO/WC	$46.90

TRAY UNIVERSAL L FACET 18153

Facility

$54.75

Hospital Charge Code	270632600
Hospital Revenue Code	272
Min. Negotiated Rate	$8.21
Max. Negotiated Rate	$8.21
Rate for Payer: Qualcare PPO/HMO/WC	$8.21

TRAY UNIVERSAL L FACET 18153

Facility

$54.75

Hospital Charge Code	270632600
Hospital Revenue Code	272
Min. Negotiated Rate	$1.32
Max. Negotiated Rate	$27.38
Rate for Payer: Aetna Commercial	$20.80
Rate for Payer: Aetna Medicare Advantage	$16.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.96
Rate for Payer: Cigna Commercial	$27.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.43
Rate for Payer: Oxford Commercial	$10.95
Rate for Payer: Qualcare PPO/HMO/WC	$8.21
Rate for Payer: UnitedHealthcare Commercial	$10.95
Rate for Payer: UnitedHealthcare Community & State	$1.32
Rate for Payer: Wellpoint Medicaid Managed Care	$1.45

TRAY URETHRAL

Facility

$1,266.45

Hospital Charge Code	270679643
Hospital Revenue Code	272
Min. Negotiated Rate	$30.52
Max. Negotiated Rate	$633.23
Rate for Payer: Aetna Commercial	$481.25
Rate for Payer: Aetna Medicare Advantage	$379.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$322.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$322.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$322.94
Rate for Payer: Cigna Commercial	$633.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$379.94
Rate for Payer: Oxford Commercial	$253.29
Rate for Payer: Qualcare PPO/HMO/WC	$189.97
Rate for Payer: UnitedHealthcare Commercial	$253.29
Rate for Payer: UnitedHealthcare Community & State	$30.52
Rate for Payer: Wellpoint Medicaid Managed Care	$33.56

TRAY URETHRAL

Facility

$1,266.45

Hospital Charge Code	270679643
Hospital Revenue Code	272
Min. Negotiated Rate	$189.97
Max. Negotiated Rate	$189.97
Rate for Payer: Qualcare PPO/HMO/WC	$189.97

Know your out-of-pocket cost for care.

All Charges