Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TUBE FREELOCK/SCP PLATE

Facility

$986.25

Hospital Charge Code	270656346
Hospital Revenue Code	271
Min. Negotiated Rate	$23.77
Max. Negotiated Rate	$493.12
Rate for Payer: Aetna Commercial	$374.77
Rate for Payer: Aetna Medicare Advantage	$295.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$251.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$251.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$251.49
Rate for Payer: Cigna Commercial	$493.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$295.88
Rate for Payer: Oxford Commercial	$197.25
Rate for Payer: Qualcare PPO/HMO/WC	$147.94
Rate for Payer: UnitedHealthcare Commercial	$197.25
Rate for Payer: UnitedHealthcare Community & State	$23.77
Rate for Payer: Wellpoint Medicaid Managed Care	$26.14

TUBE FREELOCK/SCP PLATE

Facility

$986.25

Hospital Charge Code	270656346
Hospital Revenue Code	271
Min. Negotiated Rate	$147.94
Max. Negotiated Rate	$147.94
Rate for Payer: Qualcare PPO/HMO/WC	$147.94

TUBE FREE LOCK/SCP PLATE 130

Facility

$1,138.75

Hospital Charge Code	270656334
Hospital Revenue Code	271
Min. Negotiated Rate	$27.44
Max. Negotiated Rate	$569.38
Rate for Payer: Aetna Commercial	$432.73
Rate for Payer: Aetna Medicare Advantage	$341.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$290.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$290.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$290.38
Rate for Payer: Cigna Commercial	$569.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$341.62
Rate for Payer: Oxford Commercial	$227.75
Rate for Payer: Qualcare PPO/HMO/WC	$170.81
Rate for Payer: UnitedHealthcare Commercial	$227.75
Rate for Payer: UnitedHealthcare Community & State	$27.44
Rate for Payer: Wellpoint Medicaid Managed Care	$30.18

TUBE FREE LOCK/SCP PLATE 130

Facility

$1,138.75

Hospital Charge Code	270656334
Hospital Revenue Code	271
Min. Negotiated Rate	$170.81
Max. Negotiated Rate	$170.81
Rate for Payer: Qualcare PPO/HMO/WC	$170.81

TUBE FREE LOCK/SCP PLATE 135

Facility

$1,241.25

Hospital Charge Code	270656339
Hospital Revenue Code	271
Min. Negotiated Rate	$186.19
Max. Negotiated Rate	$186.19
Rate for Payer: Qualcare PPO/HMO/WC	$186.19

TUBE FREE LOCK/SCP PLATE 135

Facility

$1,241.25

Hospital Charge Code	270656339
Hospital Revenue Code	271
Min. Negotiated Rate	$29.91
Max. Negotiated Rate	$620.62
Rate for Payer: Aetna Commercial	$471.68
Rate for Payer: Aetna Medicare Advantage	$372.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.52
Rate for Payer: Cigna Commercial	$620.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.38
Rate for Payer: Oxford Commercial	$248.25
Rate for Payer: Qualcare PPO/HMO/WC	$186.19
Rate for Payer: UnitedHealthcare Commercial	$248.25
Rate for Payer: UnitedHealthcare Community & State	$29.91
Rate for Payer: Wellpoint Medicaid Managed Care	$32.89

TUBE FREELOCK/SCP PLATE 145

Facility

$1,305.70

Hospital Charge Code	270656341
Hospital Revenue Code	271
Min. Negotiated Rate	$31.47
Max. Negotiated Rate	$652.85
Rate for Payer: Aetna Commercial	$496.17
Rate for Payer: Aetna Medicare Advantage	$391.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$332.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$332.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$332.95
Rate for Payer: Cigna Commercial	$652.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$391.71
Rate for Payer: Oxford Commercial	$261.14
Rate for Payer: Qualcare PPO/HMO/WC	$195.85
Rate for Payer: UnitedHealthcare Commercial	$261.14
Rate for Payer: UnitedHealthcare Community & State	$31.47
Rate for Payer: Wellpoint Medicaid Managed Care	$34.60

TUBE FREELOCK/SCP PLATE 145

Facility

$1,305.70

Hospital Charge Code	270656341
Hospital Revenue Code	271
Min. Negotiated Rate	$195.85
Max. Negotiated Rate	$195.85
Rate for Payer: Qualcare PPO/HMO/WC	$195.85

TUBE FREELOCK/SCP PLATE 150 DE

Facility

$1,138.75

Hospital Charge Code	270656349
Hospital Revenue Code	271
Min. Negotiated Rate	$27.44
Max. Negotiated Rate	$569.38
Rate for Payer: Aetna Commercial	$432.73
Rate for Payer: Aetna Medicare Advantage	$341.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$290.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$290.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$290.38
Rate for Payer: Cigna Commercial	$569.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$341.62
Rate for Payer: Oxford Commercial	$227.75
Rate for Payer: Qualcare PPO/HMO/WC	$170.81
Rate for Payer: UnitedHealthcare Commercial	$227.75
Rate for Payer: UnitedHealthcare Community & State	$27.44
Rate for Payer: Wellpoint Medicaid Managed Care	$30.18

TUBE FREELOCK/SCP PLATE 150 DE

Facility

$1,138.75

Hospital Charge Code	270656349
Hospital Revenue Code	271
Min. Negotiated Rate	$170.81
Max. Negotiated Rate	$170.81
Rate for Payer: Qualcare PPO/HMO/WC	$170.81

TUBE GASTRO20FR REPLA/TRL51364

Facility

$145.00

Hospital Charge Code	270102276
Hospital Revenue Code	272
Min. Negotiated Rate	$3.49
Max. Negotiated Rate	$72.50
Rate for Payer: Aetna Commercial	$55.10
Rate for Payer: Aetna Medicare Advantage	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.98
Rate for Payer: Cigna Commercial	$72.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.50
Rate for Payer: Oxford Commercial	$29.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.75
Rate for Payer: UnitedHealthcare Commercial	$29.00
Rate for Payer: UnitedHealthcare Community & State	$3.49
Rate for Payer: Wellpoint Medicaid Managed Care	$3.84

TUBE GASTRO20FR REPLA/TRL51364

Facility

$145.00

Hospital Charge Code	270102276
Hospital Revenue Code	272
Min. Negotiated Rate	$21.75
Max. Negotiated Rate	$21.75
Rate for Payer: Qualcare PPO/HMO/WC	$21.75

TUBE GASTRO ENTERIC 16FR

Facility

$844.10

Hospital Charge Code	270670058
Hospital Revenue Code	272
Min. Negotiated Rate	$126.61
Max. Negotiated Rate	$126.61
Rate for Payer: Qualcare PPO/HMO/WC	$126.61

TUBE GASTRO ENTERIC 16FR

Facility

$844.10

Hospital Charge Code	270670058
Hospital Revenue Code	272
Min. Negotiated Rate	$20.34
Max. Negotiated Rate	$422.05
Rate for Payer: Aetna Commercial	$320.76
Rate for Payer: Aetna Medicare Advantage	$253.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$215.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$215.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$215.25
Rate for Payer: Cigna Commercial	$422.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$253.23
Rate for Payer: Oxford Commercial	$168.82
Rate for Payer: Qualcare PPO/HMO/WC	$126.61
Rate for Payer: UnitedHealthcare Commercial	$168.82
Rate for Payer: UnitedHealthcare Community & State	$20.34
Rate for Payer: Wellpoint Medicaid Managed Care	$22.37

TUBE GASTROENTERIC 18F 021018

Facility

$873.00

Hospital Charge Code	270661988
Hospital Revenue Code	278
Min. Negotiated Rate	$130.95
Max. Negotiated Rate	$211.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$174.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.06
Rate for Payer: Qualcare PPO/HMO/WC	$130.95

TUBE GASTROENTERIC 18F 021018

Facility

$873.00

Hospital Charge Code	270661988
Hospital Revenue Code	278
Min. Negotiated Rate	$21.04
Max. Negotiated Rate	$436.50
Rate for Payer: Aetna Commercial	$331.74
Rate for Payer: Aetna Medicare Advantage	$261.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$222.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$222.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$174.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$222.62
Rate for Payer: Cigna Commercial	$436.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.06
Rate for Payer: Qualcare PPO/HMO/WC	$130.95
Rate for Payer: UnitedHealthcare Community & State	$21.04
Rate for Payer: Wellpoint Medicaid Managed Care	$23.13

TUBE GASTRONOMY FEEDING 24 FR

Facility

$973.10

Hospital Charge Code	270678518
Hospital Revenue Code	272
Min. Negotiated Rate	$145.97
Max. Negotiated Rate	$145.97
Rate for Payer: Qualcare PPO/HMO/WC	$145.97

TUBE GASTRONOMY FEEDING 24 FR

Facility

$973.10

Hospital Charge Code	270678518
Hospital Revenue Code	272
Min. Negotiated Rate	$23.45
Max. Negotiated Rate	$486.55
Rate for Payer: Aetna Commercial	$369.78
Rate for Payer: Aetna Medicare Advantage	$291.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.14
Rate for Payer: Cigna Commercial	$486.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.93
Rate for Payer: Oxford Commercial	$194.62
Rate for Payer: Qualcare PPO/HMO/WC	$145.97
Rate for Payer: UnitedHealthcare Commercial	$194.62
Rate for Payer: UnitedHealthcare Community & State	$23.45
Rate for Payer: Wellpoint Medicaid Managed Care	$25.79

TUBE GASTROSTMY FLEX 24F 54738

Facility

$105.00

Hospital Charge Code	270302335
Hospital Revenue Code	272
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$52.50
Rate for Payer: Aetna Commercial	$39.90
Rate for Payer: Aetna Medicare Advantage	$31.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.77
Rate for Payer: Cigna Commercial	$52.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.50
Rate for Payer: Oxford Commercial	$21.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.75
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Community & State	$2.53
Rate for Payer: Wellpoint Medicaid Managed Care	$2.78

TUBE GASTROSTMY FLEX 24F 54738

Facility

$105.00

Hospital Charge Code	270302335
Hospital Revenue Code	272
Min. Negotiated Rate	$15.75
Max. Negotiated Rate	$15.75
Rate for Payer: Qualcare PPO/HMO/WC	$15.75

TUBE GASTROSTO FLEXIFLO 20FR

Facility

$380.00

Hospital Charge Code	270601250
Hospital Revenue Code	272
Min. Negotiated Rate	$9.16
Max. Negotiated Rate	$190.00
Rate for Payer: Aetna Commercial	$144.40
Rate for Payer: Aetna Medicare Advantage	$114.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.90
Rate for Payer: Cigna Commercial	$190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.00
Rate for Payer: Oxford Commercial	$76.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.00
Rate for Payer: UnitedHealthcare Commercial	$76.00
Rate for Payer: UnitedHealthcare Community & State	$9.16
Rate for Payer: Wellpoint Medicaid Managed Care	$10.07

TUBE GASTROSTO FLEXIFLO 20FR

Facility

$380.00

Hospital Charge Code	270601250
Hospital Revenue Code	272
Min. Negotiated Rate	$57.00
Max. Negotiated Rate	$57.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.00

TUBE GASTROSTO FLEXIFLO 22FR

Facility

$380.00

Hospital Charge Code	270600961
Hospital Revenue Code	272
Min. Negotiated Rate	$57.00
Max. Negotiated Rate	$57.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.00

TUBE GASTROSTO FLEXIFLO 22FR

Facility

$380.00

Hospital Charge Code	270600961
Hospital Revenue Code	272
Min. Negotiated Rate	$9.16
Max. Negotiated Rate	$190.00
Rate for Payer: Aetna Commercial	$144.40
Rate for Payer: Aetna Medicare Advantage	$114.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.90
Rate for Payer: Cigna Commercial	$190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.00
Rate for Payer: Oxford Commercial	$76.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.00
Rate for Payer: UnitedHealthcare Commercial	$76.00
Rate for Payer: UnitedHealthcare Community & State	$9.16
Rate for Payer: Wellpoint Medicaid Managed Care	$10.07

TUBE GASTROSTO FLEXIFLO 24FR

Facility

$380.00

Hospital Charge Code	270601249
Hospital Revenue Code	272
Min. Negotiated Rate	$9.16
Max. Negotiated Rate	$190.00
Rate for Payer: Aetna Commercial	$144.40
Rate for Payer: Aetna Medicare Advantage	$114.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.90
Rate for Payer: Cigna Commercial	$190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.00
Rate for Payer: Oxford Commercial	$76.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.00
Rate for Payer: UnitedHealthcare Commercial	$76.00
Rate for Payer: UnitedHealthcare Community & State	$9.16
Rate for Payer: Wellpoint Medicaid Managed Care	$10.07

Know your out-of-pocket cost for care.

All Charges