Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TUBE ENDO UNCUFFED 4.5mm

Facility

$5.25

Hospital Charge Code	270649302
Hospital Revenue Code	272
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$2.62
Rate for Payer: Aetna Commercial	$2.00
Rate for Payer: Aetna Medicare Advantage	$1.57
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	$2.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.57
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 5.0mm

Facility

$5.25

Hospital Charge Code	270649303
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 5.0mm

Facility

$5.25

Hospital Charge Code	270649303
Hospital Revenue Code	272
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$2.62
Rate for Payer: Aetna Commercial	$2.00
Rate for Payer: Aetna Medicare Advantage	$1.57
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	$2.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.57
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 5.5mm

Facility

$14.69

Hospital Charge Code	270649304
Hospital Revenue Code	272
Min. Negotiated Rate	$2.20
Max. Negotiated Rate	$2.20
Rate for Payer: Qualcare PPO/HMO/WC	$2.20

TUBE ENDO UNCUFFED 5.5mm

Facility

$14.69

Hospital Charge Code	270649304
Hospital Revenue Code	272
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$7.34
Rate for Payer: Aetna Commercial	$5.58
Rate for Payer: Aetna Medicare Advantage	$4.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.75
Rate for Payer: Cigna Commercial	$7.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.41
Rate for Payer: Oxford Commercial	$2.94
Rate for Payer: Qualcare PPO/HMO/WC	$2.20
Rate for Payer: UnitedHealthcare Commercial	$2.94
Rate for Payer: UnitedHealthcare Community & State	$0.35
Rate for Payer: Wellpoint Medicaid Managed Care	$0.39

TUBE ENT GOODE ACTIVENT

Facility

$117.00

Hospital Charge Code	270669516
Hospital Revenue Code	272
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$17.55
Rate for Payer: Qualcare PPO/HMO/WC	$17.55

TUBE ENT GOODE ACTIVENT

Facility

$117.00

Hospital Charge Code	270669516
Hospital Revenue Code	272
Min. Negotiated Rate	$2.82
Max. Negotiated Rate	$58.50
Rate for Payer: Aetna Commercial	$44.46
Rate for Payer: Aetna Medicare Advantage	$35.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.84
Rate for Payer: Cigna Commercial	$58.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.10
Rate for Payer: Oxford Commercial	$23.40
Rate for Payer: Qualcare PPO/HMO/WC	$17.55
Rate for Payer: UnitedHealthcare Commercial	$23.40
Rate for Payer: UnitedHealthcare Community & State	$2.82
Rate for Payer: Wellpoint Medicaid Managed Care	$3.10

TUBE ENTRCHL CUFFED 6. 5-12512

Facility

$88.28

Hospital Charge Code	270643896
Hospital Revenue Code	272
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$44.14
Rate for Payer: Aetna Commercial	$33.55
Rate for Payer: Aetna Medicare Advantage	$26.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.51
Rate for Payer: Cigna Commercial	$44.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.48
Rate for Payer: Oxford Commercial	$17.66
Rate for Payer: Qualcare PPO/HMO/WC	$13.24
Rate for Payer: UnitedHealthcare Commercial	$17.66
Rate for Payer: UnitedHealthcare Community & State	$2.13
Rate for Payer: Wellpoint Medicaid Managed Care	$2.34

TUBE ENTRCHL CUFFED 6. 5-12512

Facility

$88.28

Hospital Charge Code	270643896
Hospital Revenue Code	272
Min. Negotiated Rate	$13.24
Max. Negotiated Rate	$13.24
Rate for Payer: Qualcare PPO/HMO/WC	$13.24

TUBE ENTRCHL CUFFED 7. 5-12514

Facility

$88.28

Hospital Charge Code	270643897
Hospital Revenue Code	272
Min. Negotiated Rate	$13.24
Max. Negotiated Rate	$13.24
Rate for Payer: Qualcare PPO/HMO/WC	$13.24

TUBE ENTRCHL CUFFED 7. 5-12514

Facility

$88.28

Hospital Charge Code	270643897
Hospital Revenue Code	272
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$44.14
Rate for Payer: Aetna Commercial	$33.55
Rate for Payer: Aetna Medicare Advantage	$26.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.51
Rate for Payer: Cigna Commercial	$44.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.48
Rate for Payer: Oxford Commercial	$17.66
Rate for Payer: Qualcare PPO/HMO/WC	$13.24
Rate for Payer: UnitedHealthcare Commercial	$17.66
Rate for Payer: UnitedHealthcare Community & State	$2.13
Rate for Payer: Wellpoint Medicaid Managed Care	$2.34

TUBE ENTRCHL CUFFED 8. 5-12516

Facility

$44.14

Hospital Charge Code	270643898
Hospital Revenue Code	272
Min. Negotiated Rate	$6.62
Max. Negotiated Rate	$6.62
Rate for Payer: Qualcare PPO/HMO/WC	$6.62

TUBE ENTRCHL CUFFED 8. 5-12516

Facility

$44.14

Hospital Charge Code	270643898
Hospital Revenue Code	272
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$22.07
Rate for Payer: Aetna Commercial	$16.77
Rate for Payer: Aetna Medicare Advantage	$13.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.26
Rate for Payer: Cigna Commercial	$22.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.24
Rate for Payer: Oxford Commercial	$8.83
Rate for Payer: Qualcare PPO/HMO/WC	$6.62
Rate for Payer: UnitedHealthcare Commercial	$8.83
Rate for Payer: UnitedHealthcare Community & State	$1.06
Rate for Payer: Wellpoint Medicaid Managed Care	$1.17

TUBE E PORTAL

Facility

$2,000.00

Hospital Charge Code	270674907
Hospital Revenue Code	272
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

TUBE E PORTAL

Facility

$2,000.00

Hospital Charge Code	270674907
Hospital Revenue Code	272
Min. Negotiated Rate	$48.20
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$600.00
Rate for Payer: Oxford Commercial	$400.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Commercial	$400.00
Rate for Payer: UnitedHealthcare Community & State	$48.20
Rate for Payer: Wellpoint Medicaid Managed Care	$53.00

TUBE ESOPHAGEAL NASO 20F ADULT

Facility

$738.95

Hospital Charge Code	270654068
Hospital Revenue Code	272
Min. Negotiated Rate	$110.84
Max. Negotiated Rate	$110.84
Rate for Payer: Qualcare PPO/HMO/WC	$110.84

TUBE ESOPHAGEAL NASO 20F ADULT

Facility

$738.95

Hospital Charge Code	270654068
Hospital Revenue Code	272
Min. Negotiated Rate	$17.81
Max. Negotiated Rate	$369.48
Rate for Payer: Aetna Commercial	$280.80
Rate for Payer: Aetna Medicare Advantage	$221.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$188.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$188.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$188.43
Rate for Payer: Cigna Commercial	$369.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$221.69
Rate for Payer: Oxford Commercial	$147.79
Rate for Payer: Qualcare PPO/HMO/WC	$110.84
Rate for Payer: UnitedHealthcare Commercial	$147.79
Rate for Payer: UnitedHealthcare Community & State	$17.81
Rate for Payer: Wellpoint Medicaid Managed Care	$19.58

TUBE ET SHER-I-BRONCH 35FR LT

Facility

$685.00

Hospital Charge Code	270657414
Hospital Revenue Code	272
Min. Negotiated Rate	$16.51
Max. Negotiated Rate	$342.50
Rate for Payer: Aetna Commercial	$260.30
Rate for Payer: Aetna Medicare Advantage	$205.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.68
Rate for Payer: Cigna Commercial	$342.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.50
Rate for Payer: Oxford Commercial	$137.00
Rate for Payer: Qualcare PPO/HMO/WC	$102.75
Rate for Payer: UnitedHealthcare Commercial	$137.00
Rate for Payer: UnitedHealthcare Community & State	$16.51
Rate for Payer: Wellpoint Medicaid Managed Care	$18.15

TUBE ET SHER-I-BRONCH 35FR LT

Facility

$685.00

Hospital Charge Code	270657414
Hospital Revenue Code	272
Min. Negotiated Rate	$102.75
Max. Negotiated Rate	$102.75
Rate for Payer: Qualcare PPO/HMO/WC	$102.75

TUBE ET SHER-I-BRONCH 37FR LT

Facility

$705.45

Hospital Charge Code	270652547
Hospital Revenue Code	272
Min. Negotiated Rate	$17.00
Max. Negotiated Rate	$352.73
Rate for Payer: Aetna Commercial	$268.07
Rate for Payer: Aetna Medicare Advantage	$211.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$179.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$179.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$179.89
Rate for Payer: Cigna Commercial	$352.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.63
Rate for Payer: Oxford Commercial	$141.09
Rate for Payer: Qualcare PPO/HMO/WC	$105.82
Rate for Payer: UnitedHealthcare Commercial	$141.09
Rate for Payer: UnitedHealthcare Community & State	$17.00
Rate for Payer: Wellpoint Medicaid Managed Care	$18.69

TUBE ET SHER-I-BRONCH 37FR LT

Facility

$705.45

Hospital Charge Code	270652547
Hospital Revenue Code	272
Min. Negotiated Rate	$105.82
Max. Negotiated Rate	$105.82
Rate for Payer: Qualcare PPO/HMO/WC	$105.82

TUBE EWALD *******

Facility

$55.00

Hospital Charge Code	8000689
Hospital Revenue Code	279
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

TUBE EWALD *******

Facility

$55.00

Hospital Charge Code	8000689
Hospital Revenue Code	279
Min. Negotiated Rate	$1.33
Max. Negotiated Rate	$27.50
Rate for Payer: Aetna Commercial	$20.90
Rate for Payer: Aetna Medicare Advantage	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.03
Rate for Payer: Cigna Commercial	$27.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.50
Rate for Payer: Oxford Commercial	$11.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.25
Rate for Payer: UnitedHealthcare Commercial	$11.00
Rate for Payer: UnitedHealthcare Community & State	$1.33
Rate for Payer: Wellpoint Medicaid Managed Care	$1.46

TUBE FAST TRACK ET 7.0

Facility

$335.00

Hospital Charge Code	270625558
Hospital Revenue Code	272
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$167.50
Rate for Payer: Aetna Commercial	$127.30
Rate for Payer: Aetna Medicare Advantage	$100.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.42
Rate for Payer: Cigna Commercial	$167.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.50
Rate for Payer: Oxford Commercial	$67.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.25
Rate for Payer: UnitedHealthcare Commercial	$67.00
Rate for Payer: UnitedHealthcare Community & State	$8.07
Rate for Payer: Wellpoint Medicaid Managed Care	$8.88

TUBE FAST TRACK ET 7.0

Facility

$335.00

Hospital Charge Code	270625558
Hospital Revenue Code	272
Min. Negotiated Rate	$50.25
Max. Negotiated Rate	$50.25
Rate for Payer: Qualcare PPO/HMO/WC	$50.25

Know your out-of-pocket cost for care.

All Charges