Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TREPHINE VACUUM BARRON 2056

Facility

$593.65

Hospital Charge Code	270600211
Hospital Revenue Code	272
Min. Negotiated Rate	$14.31
Max. Negotiated Rate	$296.82
Rate for Payer: Aetna Commercial	$225.59
Rate for Payer: Aetna Medicare Advantage	$178.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.38
Rate for Payer: Cigna Commercial	$296.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$178.09
Rate for Payer: Oxford Commercial	$118.73
Rate for Payer: Qualcare PPO/HMO/WC	$89.05
Rate for Payer: UnitedHealthcare Commercial	$118.73
Rate for Payer: UnitedHealthcare Community & State	$14.31
Rate for Payer: Wellpoint Medicaid Managed Care	$15.73

TREPHINE VACUUM BARRON 2056

Facility

$593.65

Hospital Charge Code	270600211
Hospital Revenue Code	272
Min. Negotiated Rate	$89.05
Max. Negotiated Rate	$89.05
Rate for Payer: Qualcare PPO/HMO/WC	$89.05

TREPHINE VACUUM BARRON 2058

Facility

$593.65

Hospital Charge Code	270600212
Hospital Revenue Code	272
Min. Negotiated Rate	$14.31
Max. Negotiated Rate	$296.82
Rate for Payer: Aetna Commercial	$225.59
Rate for Payer: Aetna Medicare Advantage	$178.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.38
Rate for Payer: Cigna Commercial	$296.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$178.09
Rate for Payer: Oxford Commercial	$118.73
Rate for Payer: Qualcare PPO/HMO/WC	$89.05
Rate for Payer: UnitedHealthcare Commercial	$118.73
Rate for Payer: UnitedHealthcare Community & State	$14.31
Rate for Payer: Wellpoint Medicaid Managed Care	$15.73

TREPHINE VACUUM BARRON 2058

Facility

$593.65

Hospital Charge Code	270600212
Hospital Revenue Code	272
Min. Negotiated Rate	$89.05
Max. Negotiated Rate	$89.05
Rate for Payer: Qualcare PPO/HMO/WC	$89.05

TREPHIN GUIDE WIRE

Facility

$283.20

Service Code	HCPCS C1713
Hospital Charge Code	270691600
Hospital Revenue Code	278
Min. Negotiated Rate	$42.48
Max. Negotiated Rate	$68.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$62.30
Rate for Payer: Qualcare PPO/HMO/WC	$42.48

TREPHIN GUIDE WIRE

Facility

$283.20

Service Code	HCPCS C1713
Hospital Charge Code	270691600
Hospital Revenue Code	278
Min. Negotiated Rate	$6.83
Max. Negotiated Rate	$141.60
Rate for Payer: Aetna Commercial	$107.62
Rate for Payer: Aetna Medicare Advantage	$84.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.22
Rate for Payer: Cigna Commercial	$141.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$62.30
Rate for Payer: Qualcare PPO/HMO/WC	$42.48
Rate for Payer: UnitedHealthcare Community & State	$6.83
Rate for Payer: Wellpoint Medicaid Managed Care	$7.50

TREPONEMA PALLIDUM AB PA

Facility

$390.00

Service Code	HCPCS 86780
Hospital Charge Code	39708008
Hospital Revenue Code	302
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$36.01
Rate for Payer: Aetna Medicare Advantage	$42.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.79
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$13.24
Rate for Payer: Clover Medicare Advantage	$12.58
Rate for Payer: EmblemHealth Commercial	$39.72
Rate for Payer: Humana Medicare Advantage	$13.64
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.59
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.24
Rate for Payer: Wellcare Medicare Advantage	$13.24
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

TREPONEMA PALLIDUM AB PA

Facility

$390.00

Service Code	HCPCS 86780
Hospital Charge Code	39708008
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

TRETINOIN CRM .05% 15GM

Facility

$227.85

Hospital Charge Code	6005391
Hospital Revenue Code	252
Min. Negotiated Rate	$5.49
Max. Negotiated Rate	$113.92
Rate for Payer: Aetna Commercial	$86.58
Rate for Payer: Aetna Medicare Advantage	$68.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.10
Rate for Payer: Cigna Commercial	$113.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.36
Rate for Payer: Oxford Commercial	$45.57
Rate for Payer: Qualcare PPO/HMO/WC	$34.18
Rate for Payer: UnitedHealthcare Commercial	$45.57
Rate for Payer: UnitedHealthcare Community & State	$5.49
Rate for Payer: Wellpoint Medicaid Managed Care	$6.04

TRETINOIN CRM .05% 15GM

Facility

$227.85

Hospital Charge Code	6005391
Hospital Revenue Code	252
Min. Negotiated Rate	$34.18
Max. Negotiated Rate	$34.18
Rate for Payer: Qualcare PPO/HMO/WC	$34.18

TRETINOIN GEL .01% 15GM

Facility

$213.80

Hospital Charge Code	6005375
Hospital Revenue Code	252
Min. Negotiated Rate	$32.07
Max. Negotiated Rate	$32.07
Rate for Payer: Qualcare PPO/HMO/WC	$32.07

TRETINOIN GEL .01% 15GM

Facility

$213.80

Hospital Charge Code	6005375
Hospital Revenue Code	252
Min. Negotiated Rate	$5.15
Max. Negotiated Rate	$106.90
Rate for Payer: Aetna Commercial	$81.24
Rate for Payer: Aetna Medicare Advantage	$64.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.52
Rate for Payer: Cigna Commercial	$106.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.14
Rate for Payer: Oxford Commercial	$42.76
Rate for Payer: Qualcare PPO/HMO/WC	$32.07
Rate for Payer: UnitedHealthcare Commercial	$42.76
Rate for Payer: UnitedHealthcare Community & State	$5.15
Rate for Payer: Wellpoint Medicaid Managed Care	$5.67

TRETINOIN GEL .025% 15GM

Facility

$181.15

Hospital Charge Code	6005383
Hospital Revenue Code	252
Min. Negotiated Rate	$4.37
Max. Negotiated Rate	$90.58
Rate for Payer: Aetna Commercial	$68.84
Rate for Payer: Aetna Medicare Advantage	$54.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.19
Rate for Payer: Cigna Commercial	$90.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.34
Rate for Payer: Oxford Commercial	$36.23
Rate for Payer: Qualcare PPO/HMO/WC	$27.17
Rate for Payer: UnitedHealthcare Commercial	$36.23
Rate for Payer: UnitedHealthcare Community & State	$4.37
Rate for Payer: Wellpoint Medicaid Managed Care	$4.80

TRETINOIN GEL .025% 15GM

Facility

$181.15

Hospital Charge Code	6005383
Hospital Revenue Code	252
Min. Negotiated Rate	$27.17
Max. Negotiated Rate	$27.17
Rate for Payer: Qualcare PPO/HMO/WC	$27.17

Trevo 3x20

Facility

$39,975.00

Hospital Charge Code	270685068N
Hospital Revenue Code	272
Min. Negotiated Rate	$963.40
Max. Negotiated Rate	$19,987.50
Rate for Payer: Aetna Commercial	$15,190.50
Rate for Payer: Aetna Medicare Advantage	$11,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,193.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,193.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,193.62
Rate for Payer: Cigna Commercial	$19,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,992.50
Rate for Payer: Oxford Commercial	$7,995.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,996.25
Rate for Payer: UnitedHealthcare Commercial	$7,995.00
Rate for Payer: UnitedHealthcare Community & State	$963.40
Rate for Payer: Wellpoint Medicaid Managed Care	$1,059.34

Trevo 3x20

Facility

$39,975.00

Hospital Charge Code	270685068S
Hospital Revenue Code	272
Min. Negotiated Rate	$963.40
Max. Negotiated Rate	$19,987.50
Rate for Payer: Aetna Commercial	$15,190.50
Rate for Payer: Aetna Medicare Advantage	$11,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,193.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,193.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,193.62
Rate for Payer: Cigna Commercial	$19,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,992.50
Rate for Payer: Oxford Commercial	$7,995.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,996.25
Rate for Payer: UnitedHealthcare Commercial	$7,995.00
Rate for Payer: UnitedHealthcare Community & State	$963.40
Rate for Payer: Wellpoint Medicaid Managed Care	$1,059.34

Trevo 3x20

Facility

$39,975.00

Hospital Charge Code	270685068S
Hospital Revenue Code	272
Min. Negotiated Rate	$5,996.25
Max. Negotiated Rate	$5,996.25
Rate for Payer: Qualcare PPO/HMO/WC	$5,996.25

Trevo 3x20

Facility

$39,975.00

Hospital Charge Code	270685068N
Hospital Revenue Code	272
Min. Negotiated Rate	$5,996.25
Max. Negotiated Rate	$5,996.25
Rate for Payer: Qualcare PPO/HMO/WC	$5,996.25

TREVO NXT 3MM X 32MM - US

Facility

$37,026.25

Hospital Charge Code	270689895S
Hospital Revenue Code	278
Min. Negotiated Rate	$892.33
Max. Negotiated Rate	$18,513.12
Rate for Payer: Aetna Commercial	$14,069.98
Rate for Payer: Aetna Medicare Advantage	$11,107.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,441.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,441.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,405.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,441.69
Rate for Payer: Cigna Commercial	$18,513.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,960.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,145.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,553.94
Rate for Payer: UnitedHealthcare Community & State	$892.33
Rate for Payer: Wellpoint Medicaid Managed Care	$981.20

TREVO NXT 3MM X 32MM - US

Facility

$37,026.25

Hospital Charge Code	270689895
Hospital Revenue Code	278
Min. Negotiated Rate	$892.33
Max. Negotiated Rate	$18,513.12
Rate for Payer: Aetna Commercial	$14,069.98
Rate for Payer: Aetna Medicare Advantage	$11,107.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,441.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,441.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,405.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,441.69
Rate for Payer: Cigna Commercial	$18,513.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,960.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,145.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,553.94
Rate for Payer: UnitedHealthcare Community & State	$892.33
Rate for Payer: Wellpoint Medicaid Managed Care	$981.20

TREVO NXT 3MM X 32MM - US

Facility

$37,026.25

Hospital Charge Code	270689895S
Hospital Revenue Code	278
Min. Negotiated Rate	$5,553.94
Max. Negotiated Rate	$8,960.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,405.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,960.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,145.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,553.94

TREVO NXT 3MM X 32MM - US

Facility

$37,026.25

Hospital Charge Code	270689895
Hospital Revenue Code	278
Min. Negotiated Rate	$5,553.94
Max. Negotiated Rate	$8,960.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,405.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,960.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,145.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,553.94

TREVO NXT 3X32+TRAK21 2-PACK

Facility

$37,976.25

Hospital Charge Code	270689891S
Hospital Revenue Code	278
Min. Negotiated Rate	$5,696.44
Max. Negotiated Rate	$9,190.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,595.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,190.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,354.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,696.44

TREVO NXT 3X32+TRAK21 2-PACK

Facility

$37,976.25

Hospital Charge Code	270689891S
Hospital Revenue Code	278
Min. Negotiated Rate	$915.23
Max. Negotiated Rate	$18,988.12
Rate for Payer: Aetna Commercial	$14,430.98
Rate for Payer: Aetna Medicare Advantage	$11,392.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,683.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,683.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,595.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,683.94
Rate for Payer: Cigna Commercial	$18,988.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,190.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,354.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,696.44
Rate for Payer: UnitedHealthcare Community & State	$915.23
Rate for Payer: Wellpoint Medicaid Managed Care	$1,006.37

TREVO NXT 3X32+TRAK21 2-PACK -

Facility

$37,976.25

Hospital Charge Code	270689891
Hospital Revenue Code	278
Min. Negotiated Rate	$915.23
Max. Negotiated Rate	$18,988.12
Rate for Payer: Aetna Commercial	$14,430.98
Rate for Payer: Aetna Medicare Advantage	$11,392.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,683.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,683.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,595.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,683.94
Rate for Payer: Cigna Commercial	$18,988.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,190.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,354.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,696.44
Rate for Payer: UnitedHealthcare Community & State	$915.23
Rate for Payer: Wellpoint Medicaid Managed Care	$1,006.37

Know your out-of-pocket cost for care.

All Charges