Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TUBE ENDOTRACHEAL 9MM

Facility

$72.00

Hospital Charge Code	270331094
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 9MM

Facility

$72.00

Hospital Charge Code	270331094
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 PEDS 3.5mm

Facility

$5.65

Hospital Charge Code	270649820
Hospital Revenue Code	272
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.85
Rate for Payer: Qualcare PPO/HMO/WC	$0.85

TUBE ENDOTRACHEAL PEDS 3.5mm

Facility

$5.65

Hospital Charge Code	270649820
Hospital Revenue Code	272
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.83
Rate for Payer: Aetna Commercial	$2.15
Rate for Payer: Aetna Medicare Advantage	$1.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.44
Rate for Payer: Cigna Commercial	$2.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.70
Rate for Payer: Oxford Commercial	$1.13
Rate for Payer: Qualcare PPO/HMO/WC	$0.85
Rate for Payer: UnitedHealthcare Commercial	$1.13
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

TUBE ENDOTRACH ORAL RAE 6.0MM

Facility

$190.20

Hospital Charge Code	270656298
Hospital Revenue Code	271
Min. Negotiated Rate	$4.58
Max. Negotiated Rate	$95.10
Rate for Payer: Aetna Commercial	$72.28
Rate for Payer: Aetna Medicare Advantage	$57.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.50
Rate for Payer: Cigna Commercial	$95.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.06
Rate for Payer: Oxford Commercial	$38.04
Rate for Payer: Qualcare PPO/HMO/WC	$28.53
Rate for Payer: UnitedHealthcare Commercial	$38.04
Rate for Payer: UnitedHealthcare Community & State	$4.58
Rate for Payer: Wellpoint Medicaid Managed Care	$5.04

TUBE ENDOTRACH ORAL RAE 6.0MM

Facility

$190.20

Hospital Charge Code	270656298
Hospital Revenue Code	271
Min. Negotiated Rate	$28.53
Max. Negotiated Rate	$28.53
Rate for Payer: Qualcare PPO/HMO/WC	$28.53

TUBE ENDOTRACH SZ 4 LOW 510108

Facility

$14.10

Hospital Charge Code	270626172
Hospital Revenue Code	272
Min. Negotiated Rate	$2.12
Max. Negotiated Rate	$2.12
Rate for Payer: Qualcare PPO/HMO/WC	$2.12

TUBE ENDOTRACH SZ 4 LOW 510108

Facility

$14.10

Hospital Charge Code	270626172
Hospital Revenue Code	272
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$7.05
Rate for Payer: Aetna Commercial	$5.36
Rate for Payer: Aetna Medicare Advantage	$4.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.60
Rate for Payer: Cigna Commercial	$7.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.23
Rate for Payer: Oxford Commercial	$2.82
Rate for Payer: Qualcare PPO/HMO/WC	$2.12
Rate for Payer: UnitedHealthcare Commercial	$2.82
Rate for Payer: UnitedHealthcare Community & State	$0.34
Rate for Payer: Wellpoint Medicaid Managed Care	$0.37

TUBE ENDOTRCHL 6NE CNT 8229506

Facility

$1,665.00

Hospital Charge Code	270639285
Hospital Revenue Code	272
Min. Negotiated Rate	$40.13
Max. Negotiated Rate	$832.50
Rate for Payer: Aetna Commercial	$632.70
Rate for Payer: Aetna Medicare Advantage	$499.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$424.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$424.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$424.57
Rate for Payer: Cigna Commercial	$832.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$499.50
Rate for Payer: Oxford Commercial	$333.00
Rate for Payer: Qualcare PPO/HMO/WC	$249.75
Rate for Payer: UnitedHealthcare Commercial	$333.00
Rate for Payer: UnitedHealthcare Community & State	$40.13
Rate for Payer: Wellpoint Medicaid Managed Care	$44.12

TUBE ENDOTRCHL 6NE CNT 8229506

Facility

$1,665.00

Hospital Charge Code	270639285
Hospital Revenue Code	272
Min. Negotiated Rate	$249.75
Max. Negotiated Rate	$249.75
Rate for Payer: Qualcare PPO/HMO/WC	$249.75

TUBE ENDOTRCHL 7NE CNT 8229507

Facility

$2,005.00

Hospital Charge Code	270639286
Hospital Revenue Code	270
Min. Negotiated Rate	$48.32
Max. Negotiated Rate	$1,002.50
Rate for Payer: Aetna Commercial	$761.90
Rate for Payer: Aetna Medicare Advantage	$601.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$511.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$511.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$511.27
Rate for Payer: Cigna Commercial	$1,002.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$601.50
Rate for Payer: Oxford Commercial	$401.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.75
Rate for Payer: UnitedHealthcare Commercial	$401.00
Rate for Payer: UnitedHealthcare Community & State	$48.32
Rate for Payer: Wellpoint Medicaid Managed Care	$53.13

TUBE ENDOTRCHL 7NE CNT 8229507

Facility

$2,005.00

Hospital Charge Code	270639286
Hospital Revenue Code	270
Min. Negotiated Rate	$300.75
Max. Negotiated Rate	$300.75
Rate for Payer: Qualcare PPO/HMO/WC	$300.75

TUBE ENDOTRCHL 8NE CNT

Facility

$1,695.00

Hospital Charge Code	270639287
Hospital Revenue Code	270
Min. Negotiated Rate	$40.85
Max. Negotiated Rate	$847.50
Rate for Payer: Aetna Commercial	$644.10
Rate for Payer: Aetna Medicare Advantage	$508.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$432.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$432.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$432.23
Rate for Payer: Cigna Commercial	$847.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$508.50
Rate for Payer: Oxford Commercial	$339.00
Rate for Payer: Qualcare PPO/HMO/WC	$254.25
Rate for Payer: UnitedHealthcare Commercial	$339.00
Rate for Payer: UnitedHealthcare Community & State	$40.85
Rate for Payer: Wellpoint Medicaid Managed Care	$44.92

TUBE ENDOTRCHL 8NE CNT

Facility

$1,695.00

Hospital Charge Code	270639287
Hospital Revenue Code	270
Min. Negotiated Rate	$254.25
Max. Negotiated Rate	$254.25
Rate for Payer: Qualcare PPO/HMO/WC	$254.25

TUBE ENDOTR CUFF #5 LOW 510109

Facility

$14.15

Hospital Charge Code	270626173
Hospital Revenue Code	272
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$7.08
Rate for Payer: Aetna Commercial	$5.38
Rate for Payer: Aetna Medicare Advantage	$4.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.61
Rate for Payer: Cigna Commercial	$7.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.25
Rate for Payer: Oxford Commercial	$2.83
Rate for Payer: Qualcare PPO/HMO/WC	$2.12
Rate for Payer: UnitedHealthcare Commercial	$2.83
Rate for Payer: UnitedHealthcare Community & State	$0.34
Rate for Payer: Wellpoint Medicaid Managed Care	$0.37

TUBE ENDOTR CUFF #5 LOW 510109

Facility

$14.15

Hospital Charge Code	270626173
Hospital Revenue Code	272
Min. Negotiated Rate	$2.12
Max. Negotiated Rate	$2.12
Rate for Payer: Qualcare PPO/HMO/WC	$2.12

TUBE ENDO UNCUFFED 2.0mm

Facility

$5.66

Hospital Charge Code	270649297
Hospital Revenue Code	272
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.85
Rate for Payer: Qualcare PPO/HMO/WC	$0.85

TUBE ENDO UNCUFFED 2.0mm

Facility

$5.66

Hospital Charge Code	270649297
Hospital Revenue Code	272
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.83
Rate for Payer: Aetna Commercial	$2.15
Rate for Payer: Aetna Medicare Advantage	$1.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.44
Rate for Payer: Cigna Commercial	$2.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.70
Rate for Payer: Oxford Commercial	$1.13
Rate for Payer: Qualcare PPO/HMO/WC	$0.85
Rate for Payer: UnitedHealthcare Commercial	$1.13
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

TUBE ENDO UNCUFFED 2.5mm

Facility

$5.66

Hospital Charge Code	270649298
Hospital Revenue Code	272
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.85
Rate for Payer: Qualcare PPO/HMO/WC	$0.85

TUBE ENDO UNCUFFED 2.5mm

Facility

$5.66

Hospital Charge Code	270649298
Hospital Revenue Code	272
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.83
Rate for Payer: Aetna Commercial	$2.15
Rate for Payer: Aetna Medicare Advantage	$1.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.44
Rate for Payer: Cigna Commercial	$2.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.70
Rate for Payer: Oxford Commercial	$1.13
Rate for Payer: Qualcare PPO/HMO/WC	$0.85
Rate for Payer: UnitedHealthcare Commercial	$1.13
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

TUBE ENDO UNCUFFED 3.0mm

Facility

$5.66

Hospital Charge Code	270649299
Hospital Revenue Code	272
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.85
Rate for Payer: Qualcare PPO/HMO/WC	$0.85

TUBE ENDO UNCUFFED 3.0mm

Facility

$5.66

Hospital Charge Code	270649299
Hospital Revenue Code	272
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.83
Rate for Payer: Aetna Commercial	$2.15
Rate for Payer: Aetna Medicare Advantage	$1.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.44
Rate for Payer: Cigna Commercial	$2.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.70
Rate for Payer: Oxford Commercial	$1.13
Rate for Payer: Qualcare PPO/HMO/WC	$0.85
Rate for Payer: UnitedHealthcare Commercial	$1.13
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

TUBE ENDO UNCUFFED 4.0mm

Facility

$5.27

Hospital Charge Code	270649301
Hospital Revenue Code	272
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$2.63
Rate for Payer: Aetna Commercial	$2.00
Rate for Payer: Aetna Medicare Advantage	$1.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.34
Rate for Payer: Cigna Commercial	$2.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.58
Rate for Payer: Oxford Commercial	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$0.79
Rate for Payer: UnitedHealthcare Commercial	$1.05
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.14

TUBE ENDO UNCUFFED 4.0mm

Facility

$5.27

Hospital Charge Code	270649301
Hospital Revenue Code	272
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$0.79
Rate for Payer: Qualcare PPO/HMO/WC	$0.79

TUBE ENDO UNCUFFED 4.5mm

Facility

$5.25

Hospital Charge Code	270649302
Hospital Revenue Code	272
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$0.79
Rate for Payer: Qualcare PPO/HMO/WC	$0.79

Know your out-of-pocket cost for care.

All Charges