Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TUBE ENDOTRACH 9.0MM 7.36

Facility

$19.25

Hospital Charge Code	270070170
Hospital Revenue Code	272
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$2.89
Rate for Payer: Qualcare PPO/HMO/WC	$2.89

TUBE ENDOTRACH 9.0MM 7.36

Facility

$19.25

Hospital Charge Code	270070170
Hospital Revenue Code	272
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$9.62
Rate for Payer: Aetna Commercial	$7.32
Rate for Payer: Aetna Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.91
Rate for Payer: Cigna Commercial	$9.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.78
Rate for Payer: Oxford Commercial	$3.85
Rate for Payer: Qualcare PPO/HMO/WC	$2.89
Rate for Payer: UnitedHealthcare Commercial	$3.85
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.51

TUBE ENDOTRACH 9.5MM *******

Facility

$12.00

Hospital Charge Code	8000614
Hospital Revenue Code	279
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

TUBE ENDOTRACH 9.5MM *******

Facility

$12.00

Hospital Charge Code	8000614
Hospital Revenue Code	279
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$4.56
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.60
Rate for Payer: Oxford Commercial	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$2.40
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

TUBE ENDOTRACHEAL 10MM

Facility

$72.00

Hospital Charge Code	270331095
Hospital Revenue Code	272
Min. Negotiated Rate	$10.80
Max. Negotiated Rate	$10.80
Rate for Payer: Qualcare PPO/HMO/WC	$10.80

TUBE ENDOTRACHEAL 10MM

Facility

$72.00

Hospital Charge Code	270331095
Hospital Revenue Code	272
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$36.00
Rate for Payer: Aetna Commercial	$27.36
Rate for Payer: Aetna Medicare Advantage	$21.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.36
Rate for Payer: Cigna Commercial	$36.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.60
Rate for Payer: Oxford Commercial	$14.40
Rate for Payer: Qualcare PPO/HMO/WC	$10.80
Rate for Payer: UnitedHealthcare Commercial	$14.40
Rate for Payer: UnitedHealthcare Community & State	$1.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1.91

TUBE ENDOTRACHEAL 2.5mm

Facility

$8.24

Hospital Charge Code	270649821
Hospital Revenue Code	270
Min. Negotiated Rate	$1.24
Max. Negotiated Rate	$1.24
Rate for Payer: Qualcare PPO/HMO/WC	$1.24

TUBE ENDOTRACHEAL 2.5mm

Facility

$8.24

Hospital Charge Code	270649821
Hospital Revenue Code	270
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$4.12
Rate for Payer: Aetna Commercial	$3.13
Rate for Payer: Aetna Medicare Advantage	$2.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.10
Rate for Payer: Cigna Commercial	$4.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.47
Rate for Payer: Oxford Commercial	$1.65
Rate for Payer: Qualcare PPO/HMO/WC	$1.24
Rate for Payer: UnitedHealthcare Commercial	$1.65
Rate for Payer: UnitedHealthcare Community & State	$0.20
Rate for Payer: Wellpoint Medicaid Managed Care	$0.22

TUBE ENDOTRACHEAL 3.0mm

Facility

$5.37

Hospital Charge Code	270649822
Hospital Revenue Code	270
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$0.81
Rate for Payer: Qualcare PPO/HMO/WC	$0.81

TUBE ENDOTRACHEAL 3.0mm

Facility

$5.37

Hospital Charge Code	270649822
Hospital Revenue Code	270
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$2.69
Rate for Payer: Aetna Commercial	$2.04
Rate for Payer: Aetna Medicare Advantage	$1.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.37
Rate for Payer: Cigna Commercial	$2.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.61
Rate for Payer: Oxford Commercial	$1.07
Rate for Payer: Qualcare PPO/HMO/WC	$0.81
Rate for Payer: UnitedHealthcare Commercial	$1.07
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.14

TUBE ENDOTRACHEAL 4.0mm

Facility

$7.18

Hospital Charge Code	270649830
Hospital Revenue Code	270
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$1.08
Rate for Payer: Qualcare PPO/HMO/WC	$1.08

TUBE ENDOTRACHEAL 4.0mm

Facility

$7.18

Hospital Charge Code	270649830
Hospital Revenue Code	270
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.59
Rate for Payer: Aetna Commercial	$2.73
Rate for Payer: Aetna Medicare Advantage	$2.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.83
Rate for Payer: Cigna Commercial	$3.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.15
Rate for Payer: Oxford Commercial	$1.44
Rate for Payer: Qualcare PPO/HMO/WC	$1.08
Rate for Payer: UnitedHealthcare Commercial	$1.44
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

TUBE ENDOTRACHEAL 4.5mm

Facility

$7.02

Hospital Charge Code	270650107
Hospital Revenue Code	270
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

TUBE ENDOTRACHEAL 4.5mm

Facility

$7.02

Hospital Charge Code	270650107
Hospital Revenue Code	270
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.51
Rate for Payer: Aetna Commercial	$2.67
Rate for Payer: Aetna Medicare Advantage	$2.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.79
Rate for Payer: Cigna Commercial	$3.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.11
Rate for Payer: Oxford Commercial	$1.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$1.40
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

TUBE ENDOTRACHEAL 5.0mm

Facility

$11.18

Hospital Charge Code	270650108
Hospital Revenue Code	270
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$1.68
Rate for Payer: Qualcare PPO/HMO/WC	$1.68

TUBE ENDOTRACHEAL 5.0mm

Facility

$11.18

Hospital Charge Code	270650108
Hospital Revenue Code	270
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$5.59
Rate for Payer: Aetna Commercial	$4.25
Rate for Payer: Aetna Medicare Advantage	$3.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.85
Rate for Payer: Cigna Commercial	$5.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.35
Rate for Payer: Oxford Commercial	$2.24
Rate for Payer: Qualcare PPO/HMO/WC	$1.68
Rate for Payer: UnitedHealthcare Commercial	$2.24
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.30

TUBE ENDOTRACHEAL 5.5mm

Facility

$16.46

Hospital Charge Code	270650109
Hospital Revenue Code	270
Min. Negotiated Rate	$2.47
Max. Negotiated Rate	$2.47
Rate for Payer: Qualcare PPO/HMO/WC	$2.47

TUBE ENDOTRACHEAL 5.5mm

Facility

$16.46

Hospital Charge Code	270650109
Hospital Revenue Code	270
Min. Negotiated Rate	$0.40
Max. Negotiated Rate	$8.23
Rate for Payer: Aetna Commercial	$6.25
Rate for Payer: Aetna Medicare Advantage	$4.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.20
Rate for Payer: Cigna Commercial	$8.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.94
Rate for Payer: Oxford Commercial	$3.29
Rate for Payer: Qualcare PPO/HMO/WC	$2.47
Rate for Payer: UnitedHealthcare Commercial	$3.29
Rate for Payer: UnitedHealthcare Community & State	$0.40
Rate for Payer: Wellpoint Medicaid Managed Care	$0.44

TUBE ENDOTRACHEAL 5MM

Facility

$72.00

Hospital Charge Code	270331091
Hospital Revenue Code	272
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$36.00
Rate for Payer: Aetna Commercial	$27.36
Rate for Payer: Aetna Medicare Advantage	$21.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.36
Rate for Payer: Cigna Commercial	$36.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.60
Rate for Payer: Oxford Commercial	$14.40
Rate for Payer: Qualcare PPO/HMO/WC	$10.80
Rate for Payer: UnitedHealthcare Commercial	$14.40
Rate for Payer: UnitedHealthcare Community & State	$1.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1.91

TUBE ENDOTRACHEAL 5MM

Facility

$72.00

Hospital Charge Code	270331091
Hospital Revenue Code	272
Min. Negotiated Rate	$10.80
Max. Negotiated Rate	$10.80
Rate for Payer: Qualcare PPO/HMO/WC	$10.80

TUBE ENDOTRACHEAL 6.0mm

Facility

$111.80

Hospital Charge Code	270649823
Hospital Revenue Code	272
Min. Negotiated Rate	$16.77
Max. Negotiated Rate	$16.77
Rate for Payer: Qualcare PPO/HMO/WC	$16.77

TUBE ENDOTRACHEAL 6.0mm

Facility

$111.80

Hospital Charge Code	270649823
Hospital Revenue Code	272
Min. Negotiated Rate	$2.69
Max. Negotiated Rate	$55.90
Rate for Payer: Aetna Commercial	$42.48
Rate for Payer: Aetna Medicare Advantage	$33.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.51
Rate for Payer: Cigna Commercial	$55.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.54
Rate for Payer: Oxford Commercial	$22.36
Rate for Payer: Qualcare PPO/HMO/WC	$16.77
Rate for Payer: UnitedHealthcare Commercial	$22.36
Rate for Payer: UnitedHealthcare Community & State	$2.69
Rate for Payer: Wellpoint Medicaid Managed Care	$2.96

TUBE ENDOTRACHEAL 6.5MM

Facility

$11.18

Hospital Charge Code	270649932
Hospital Revenue Code	272
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$1.68
Rate for Payer: Qualcare PPO/HMO/WC	$1.68

TUBE ENDOTRACHEAL 6.5MM

Facility

$11.18

Hospital Charge Code	270649932
Hospital Revenue Code	272
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$5.59
Rate for Payer: Aetna Commercial	$4.25
Rate for Payer: Aetna Medicare Advantage	$3.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.85
Rate for Payer: Cigna Commercial	$5.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.35
Rate for Payer: Oxford Commercial	$2.24
Rate for Payer: Qualcare PPO/HMO/WC	$1.68
Rate for Payer: UnitedHealthcare Commercial	$2.24
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.30

TUBE ENDOTRACHEAL 6.5MM

Facility

$48.00

Hospital Charge Code	270331312
Hospital Revenue Code	272
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$7.20
Rate for Payer: Qualcare PPO/HMO/WC	$7.20

Know your out-of-pocket cost for care.

All Charges