Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

T-TRANSGLUTAMINASE IGA

Facility

$121.00

Service Code	HCPCS 83516
Hospital Charge Code	3038119
Hospital Revenue Code	300
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$18.15

T-TRANSGLUTAMINASE IGA

Facility

$121.00

Service Code	HCPCS 83516
Hospital Charge Code	3038119
Hospital Revenue Code	300
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$31.36
Rate for Payer: Aetna Medicare Advantage	$37.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.62
Rate for Payer: Cigna Commercial	$60.50
Rate for Payer: Cigna Medicare Advantage	$11.53
Rate for Payer: Clover Medicare Advantage	$10.95
Rate for Payer: EmblemHealth Commercial	$34.59
Rate for Payer: Humana Medicare Advantage	$11.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.15
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.53
Rate for Payer: Wellcare Medicare Advantage	$11.53
Rate for Payer: Wellpoint Medicaid Managed Care	$3.21

TTR DNA SEQUENCE TST WHOLE BLD

Facility

$1,215.00

Service Code	HCPCS 81404
Hospital Charge Code	401381404
Hospital Revenue Code	310
Min. Negotiated Rate	$32.20
Max. Negotiated Rate	$992.05
Rate for Payer: Aetna Commercial	$747.54
Rate for Payer: Aetna Medicare Advantage	$890.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$992.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$992.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$274.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$992.05
Rate for Payer: Cigna Commercial	$607.50
Rate for Payer: Cigna Medicare Advantage	$274.83
Rate for Payer: Clover Medicare Advantage	$261.09
Rate for Payer: EmblemHealth Commercial	$824.49
Rate for Payer: Humana Medicare Advantage	$283.07
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$274.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$182.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$219.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$274.83
Rate for Payer: Wellcare Medicare Advantage	$274.83
Rate for Payer: Wellpoint Medicaid Managed Care	$32.20

TTR DNA SEQUENCE TST WHOLE BLD

Facility

$1,215.00

Service Code	HCPCS 81404
Hospital Charge Code	401381404
Hospital Revenue Code	310
Min. Negotiated Rate	$182.25
Max. Negotiated Rate	$182.25
Rate for Payer: Qualcare PPO/HMO/WC	$182.25

TT REM OF THYROID

Facility

$15,267.90

Service Code	HCPCS 60270
Hospital Charge Code	1600000787
Hospital Revenue Code	360
Min. Negotiated Rate	$367.96
Max. Negotiated Rate	$7,633.95
Rate for Payer: Aetna Commercial	$5,801.80
Rate for Payer: Aetna Medicare Advantage	$4,580.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,893.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,893.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,893.31
Rate for Payer: Cigna Commercial	$7,633.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,580.37
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,290.18
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$367.96
Rate for Payer: Wellpoint Medicaid Managed Care	$404.60

TT REM OF THYROID

Facility

$15,267.90

Service Code	HCPCS 60270
Hospital Charge Code	1600000787
Hospital Revenue Code	360
Min. Negotiated Rate	$2,290.18
Max. Negotiated Rate	$2,290.18
Rate for Payer: Qualcare PPO/HMO/WC	$2,290.18

TUBE 2 REPL CURVED 16FR

Facility

$158.90

Hospital Charge Code	270673191
Hospital Revenue Code	272
Min. Negotiated Rate	$23.84
Max. Negotiated Rate	$23.84
Rate for Payer: Qualcare PPO/HMO/WC	$23.84

TUBE 2 REPL CURVED 16FR

Facility

$158.90

Hospital Charge Code	270673191
Hospital Revenue Code	272
Min. Negotiated Rate	$3.83
Max. Negotiated Rate	$79.45
Rate for Payer: Aetna Commercial	$60.38
Rate for Payer: Aetna Medicare Advantage	$47.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.52
Rate for Payer: Cigna Commercial	$79.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.67
Rate for Payer: Oxford Commercial	$31.78
Rate for Payer: Qualcare PPO/HMO/WC	$23.84
Rate for Payer: UnitedHealthcare Commercial	$31.78
Rate for Payer: UnitedHealthcare Community & State	$3.83
Rate for Payer: Wellpoint Medicaid Managed Care	$4.21

TUBE 2 REPL CURVED 18FR

Facility

$158.90

Hospital Charge Code	270673192
Hospital Revenue Code	272
Min. Negotiated Rate	$23.84
Max. Negotiated Rate	$23.84
Rate for Payer: Qualcare PPO/HMO/WC	$23.84

TUBE 2 REPL CURVED 18FR

Facility

$158.90

Hospital Charge Code	270673192
Hospital Revenue Code	272
Min. Negotiated Rate	$3.83
Max. Negotiated Rate	$79.45
Rate for Payer: Aetna Commercial	$60.38
Rate for Payer: Aetna Medicare Advantage	$47.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.52
Rate for Payer: Cigna Commercial	$79.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.67
Rate for Payer: Oxford Commercial	$31.78
Rate for Payer: Qualcare PPO/HMO/WC	$23.84
Rate for Payer: UnitedHealthcare Commercial	$31.78
Rate for Payer: UnitedHealthcare Community & State	$3.83
Rate for Payer: Wellpoint Medicaid Managed Care	$4.21

TUBE 4.0 CUFFED ORAL REA

Facility

$187.45

Hospital Charge Code	270655762
Hospital Revenue Code	271
Min. Negotiated Rate	$28.12
Max. Negotiated Rate	$28.12
Rate for Payer: Qualcare PPO/HMO/WC	$28.12

TUBE 4.0 CUFFED ORAL REA

Facility

$187.45

Hospital Charge Code	270655762
Hospital Revenue Code	271
Min. Negotiated Rate	$4.52
Max. Negotiated Rate	$93.72
Rate for Payer: Aetna Commercial	$71.23
Rate for Payer: Aetna Medicare Advantage	$56.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.80
Rate for Payer: Cigna Commercial	$93.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.23
Rate for Payer: Oxford Commercial	$37.49
Rate for Payer: Qualcare PPO/HMO/WC	$28.12
Rate for Payer: UnitedHealthcare Commercial	$37.49
Rate for Payer: UnitedHealthcare Community & State	$4.52
Rate for Payer: Wellpoint Medicaid Managed Care	$4.97

TUBE 48' HIGH PRESS CP47078000

Facility

$18.45

Hospital Charge Code	270601496
Hospital Revenue Code	272
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$9.22
Rate for Payer: Aetna Commercial	$7.01
Rate for Payer: Aetna Medicare Advantage	$5.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.70
Rate for Payer: Cigna Commercial	$9.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.54
Rate for Payer: Oxford Commercial	$3.69
Rate for Payer: Qualcare PPO/HMO/WC	$2.77
Rate for Payer: UnitedHealthcare Commercial	$3.69
Rate for Payer: UnitedHealthcare Community & State	$0.44
Rate for Payer: Wellpoint Medicaid Managed Care	$0.49

TUBE 48' HIGH PRESS CP47078000

Facility

$18.45

Hospital Charge Code	270601496
Hospital Revenue Code	272
Min. Negotiated Rate	$2.77
Max. Negotiated Rate	$2.77
Rate for Payer: Qualcare PPO/HMO/WC	$2.77

TUBE, 72 LOW PRESSURE EXTENSO

Facility

$640.00

Hospital Charge Code	270654228
Hospital Revenue Code	272
Min. Negotiated Rate	$15.42
Max. Negotiated Rate	$320.00
Rate for Payer: Aetna Commercial	$243.20
Rate for Payer: Aetna Medicare Advantage	$192.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$163.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$163.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$163.20
Rate for Payer: Cigna Commercial	$320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.00
Rate for Payer: Oxford Commercial	$128.00
Rate for Payer: Qualcare PPO/HMO/WC	$96.00
Rate for Payer: UnitedHealthcare Commercial	$128.00
Rate for Payer: UnitedHealthcare Community & State	$15.42
Rate for Payer: Wellpoint Medicaid Managed Care	$16.96

TUBE, 72 LOW PRESSURE EXTENSO

Facility

$640.00

Hospital Charge Code	270654228
Hospital Revenue Code	272
Min. Negotiated Rate	$96.00
Max. Negotiated Rate	$96.00
Rate for Payer: Qualcare PPO/HMO/WC	$96.00

TUBE AFT DIVERTED 3/4 FILL

Facility

$1,325.00

Hospital Charge Code	270674910
Hospital Revenue Code	272
Min. Negotiated Rate	$31.93
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$503.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$397.50
Rate for Payer: Oxford Commercial	$265.00
Rate for Payer: Qualcare PPO/HMO/WC	$198.75
Rate for Payer: UnitedHealthcare Commercial	$265.00
Rate for Payer: UnitedHealthcare Community & State	$31.93
Rate for Payer: Wellpoint Medicaid Managed Care	$35.11

TUBE AFT DIVERTED 3/4 FILL

Facility

$1,325.00

Hospital Charge Code	270674910
Hospital Revenue Code	272
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$198.75
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

TUBE AFT STRAIGHT 1/2 FILL

Facility

$900.00

Hospital Charge Code	270674909
Hospital Revenue Code	272
Min. Negotiated Rate	$21.69
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$270.00
Rate for Payer: Oxford Commercial	$180.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Commercial	$180.00
Rate for Payer: UnitedHealthcare Community & State	$21.69
Rate for Payer: Wellpoint Medicaid Managed Care	$23.85

TUBE AFT STRAIGHT 1/2 FILL

Facility

$900.00

Hospital Charge Code	270674909
Hospital Revenue Code	272
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$135.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

TUBE ARMSTRONG BEVELED GROMMET

Facility

$61.53

Hospital Charge Code	270659919
Hospital Revenue Code	270
Min. Negotiated Rate	$9.23
Max. Negotiated Rate	$9.23
Rate for Payer: Qualcare PPO/HMO/WC	$9.23

TUBE ARMSTRONG BEVELED GROMMET

Facility

$61.53

Hospital Charge Code	270659919
Hospital Revenue Code	270
Min. Negotiated Rate	$1.48
Max. Negotiated Rate	$30.77
Rate for Payer: Aetna Commercial	$23.38
Rate for Payer: Aetna Medicare Advantage	$18.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.69
Rate for Payer: Cigna Commercial	$30.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.46
Rate for Payer: Oxford Commercial	$12.31
Rate for Payer: Qualcare PPO/HMO/WC	$9.23
Rate for Payer: UnitedHealthcare Commercial	$12.31
Rate for Payer: UnitedHealthcare Community & State	$1.48
Rate for Payer: Wellpoint Medicaid Managed Care	$1.63

TUBE ARMSTRONG VENT ******

Facility

$84.00

Hospital Charge Code	1608124
Hospital Revenue Code	272
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.60

TUBE ARMSTRONG VENT ******

Facility

$84.00

Hospital Charge Code	1608124
Hospital Revenue Code	272
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

TUBE ARMSTRONG VENT *******

Facility

$28.00

Hospital Charge Code	1600675
Hospital Revenue Code	272
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

Know your out-of-pocket cost for care.

All Charges