Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TUBE GASTROSTO FLEXIFLO 24FR

Facility

$380.00

Hospital Charge Code	270601249
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 REPLCM

Facility

$380.00

Hospital Charge Code	270600962
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 REPLCM

Facility

$380.00

Hospital Charge Code	270600962
Hospital Revenue Code	272
Min. Negotiated Rate	$57.00
Max. Negotiated Rate	$57.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.00

TUBE GASTROSTOMY 14FR 5cc

Facility

$79.93

Hospital Charge Code	270647456
Hospital Revenue Code	271
Min. Negotiated Rate	$11.99
Max. Negotiated Rate	$11.99
Rate for Payer: Qualcare PPO/HMO/WC	$11.99

TUBE GASTROSTOMY 14FR 5cc

Facility

$79.93

Hospital Charge Code	270647456
Hospital Revenue Code	271
Min. Negotiated Rate	$1.93
Max. Negotiated Rate	$39.97
Rate for Payer: Aetna Commercial	$30.37
Rate for Payer: Aetna Medicare Advantage	$23.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.38
Rate for Payer: Cigna Commercial	$39.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.98
Rate for Payer: Oxford Commercial	$15.99
Rate for Payer: Qualcare PPO/HMO/WC	$11.99
Rate for Payer: UnitedHealthcare Commercial	$15.99
Rate for Payer: UnitedHealthcare Community & State	$1.93
Rate for Payer: Wellpoint Medicaid Managed Care	$2.12

TUBE GASTROSTOMY 22FR 6222

Facility

$136.50

Hospital Charge Code	270624936
Hospital Revenue Code	272
Min. Negotiated Rate	$3.29
Max. Negotiated Rate	$68.25
Rate for Payer: Aetna Commercial	$51.87
Rate for Payer: Aetna Medicare Advantage	$40.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.81
Rate for Payer: Cigna Commercial	$68.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.95
Rate for Payer: Oxford Commercial	$27.30
Rate for Payer: Qualcare PPO/HMO/WC	$20.48
Rate for Payer: UnitedHealthcare Commercial	$27.30
Rate for Payer: UnitedHealthcare Community & State	$3.29
Rate for Payer: Wellpoint Medicaid Managed Care	$3.62

TUBE GASTROSTOMY 22FR 6222

Facility

$136.50

Hospital Charge Code	270624936
Hospital Revenue Code	272
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$20.48
Rate for Payer: Qualcare PPO/HMO/WC	$20.48

TUBE GASTROSTOMY 24FR

Facility

$380.40

Hospital Charge Code	270650026
Hospital Revenue Code	270
Min. Negotiated Rate	$57.06
Max. Negotiated Rate	$57.06
Rate for Payer: Qualcare PPO/HMO/WC	$57.06

TUBE GASTROSTOMY 24FR

Facility

$380.40

Hospital Charge Code	270650026
Hospital Revenue Code	270
Min. Negotiated Rate	$9.17
Max. Negotiated Rate	$190.20
Rate for Payer: Aetna Commercial	$144.55
Rate for Payer: Aetna Medicare Advantage	$114.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.00
Rate for Payer: Cigna Commercial	$190.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.12
Rate for Payer: Oxford Commercial	$76.08
Rate for Payer: Qualcare PPO/HMO/WC	$57.06
Rate for Payer: UnitedHealthcare Commercial	$76.08
Rate for Payer: UnitedHealthcare Community & State	$9.17
Rate for Payer: Wellpoint Medicaid Managed Care	$10.08

TUBE GASTROSTOMY 24FR RL54738

Facility

$21.50

Hospital Charge Code	270650438
Hospital Revenue Code	272
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$10.75
Rate for Payer: Aetna Commercial	$8.17
Rate for Payer: Aetna Medicare Advantage	$6.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.48
Rate for Payer: Cigna Commercial	$10.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.45
Rate for Payer: Oxford Commercial	$4.30
Rate for Payer: Qualcare PPO/HMO/WC	$3.23
Rate for Payer: UnitedHealthcare Commercial	$4.30
Rate for Payer: UnitedHealthcare Community & State	$0.52
Rate for Payer: Wellpoint Medicaid Managed Care	$0.57

TUBE GASTROSTOMY 24FR RL54738

Facility

$21.50

Hospital Charge Code	270650438
Hospital Revenue Code	272
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$3.23
Rate for Payer: Qualcare PPO/HMO/WC	$3.23

TUBE GASTROSTOMY MIC 16FR

Facility

$220.30

Hospital Charge Code	270672029
Hospital Revenue Code	272
Min. Negotiated Rate	$5.31
Max. Negotiated Rate	$110.15
Rate for Payer: Aetna Commercial	$83.71
Rate for Payer: Aetna Medicare Advantage	$66.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.18
Rate for Payer: Cigna Commercial	$110.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.09
Rate for Payer: Oxford Commercial	$44.06
Rate for Payer: Qualcare PPO/HMO/WC	$33.05
Rate for Payer: UnitedHealthcare Commercial	$44.06
Rate for Payer: UnitedHealthcare Community & State	$5.31
Rate for Payer: Wellpoint Medicaid Managed Care	$5.84

TUBE GASTROSTOMY MIC 16FR

Facility

$220.30

Hospital Charge Code	270672029N
Hospital Revenue Code	272
Min. Negotiated Rate	$33.05
Max. Negotiated Rate	$33.05
Rate for Payer: Qualcare PPO/HMO/WC	$33.05

TUBE GASTROSTOMY MIC 16FR

Facility

$220.30

Hospital Charge Code	270672029N
Hospital Revenue Code	272
Min. Negotiated Rate	$5.31
Max. Negotiated Rate	$110.15
Rate for Payer: Aetna Commercial	$83.71
Rate for Payer: Aetna Medicare Advantage	$66.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.18
Rate for Payer: Cigna Commercial	$110.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.09
Rate for Payer: Oxford Commercial	$44.06
Rate for Payer: Qualcare PPO/HMO/WC	$33.05
Rate for Payer: UnitedHealthcare Commercial	$44.06
Rate for Payer: UnitedHealthcare Community & State	$5.31
Rate for Payer: Wellpoint Medicaid Managed Care	$5.84

TUBE GASTROSTOMY MIC 16FR

Facility

$220.30

Hospital Charge Code	270672029
Hospital Revenue Code	272
Min. Negotiated Rate	$33.05
Max. Negotiated Rate	$33.05
Rate for Payer: Qualcare PPO/HMO/WC	$33.05

TUBE GASTROSTOMY MIC 18FR

Facility

$220.30

Hospital Charge Code	270669889
Hospital Revenue Code	272
Min. Negotiated Rate	$5.31
Max. Negotiated Rate	$110.15
Rate for Payer: Aetna Commercial	$83.71
Rate for Payer: Aetna Medicare Advantage	$66.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.18
Rate for Payer: Cigna Commercial	$110.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.09
Rate for Payer: Oxford Commercial	$44.06
Rate for Payer: Qualcare PPO/HMO/WC	$33.05
Rate for Payer: UnitedHealthcare Commercial	$44.06
Rate for Payer: UnitedHealthcare Community & State	$5.31
Rate for Payer: Wellpoint Medicaid Managed Care	$5.84

TUBE GASTROSTOMY MIC 18FR

Facility

$873.00

Hospital Charge Code	270661988S
Hospital Revenue Code	272
Min. Negotiated Rate	$130.95
Max. Negotiated Rate	$130.95
Rate for Payer: Qualcare PPO/HMO/WC	$130.95

TUBE GASTROSTOMY MIC 18FR

Facility

$152.45

Hospital Charge Code	270661988N
Hospital Revenue Code	272
Min. Negotiated Rate	$3.67
Max. Negotiated Rate	$76.22
Rate for Payer: Aetna Commercial	$57.93
Rate for Payer: Aetna Medicare Advantage	$45.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.87
Rate for Payer: Cigna Commercial	$76.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.73
Rate for Payer: Oxford Commercial	$30.49
Rate for Payer: Qualcare PPO/HMO/WC	$22.87
Rate for Payer: UnitedHealthcare Commercial	$30.49
Rate for Payer: UnitedHealthcare Community & State	$3.67
Rate for Payer: Wellpoint Medicaid Managed Care	$4.04

TUBE GASTROSTOMY MIC 18FR

Facility

$220.30

Hospital Charge Code	270669889S
Hospital Revenue Code	272
Min. Negotiated Rate	$5.31
Max. Negotiated Rate	$110.15
Rate for Payer: Aetna Commercial	$83.71
Rate for Payer: Aetna Medicare Advantage	$66.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.18
Rate for Payer: Cigna Commercial	$110.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.09
Rate for Payer: Oxford Commercial	$44.06
Rate for Payer: Qualcare PPO/HMO/WC	$33.05
Rate for Payer: UnitedHealthcare Commercial	$44.06
Rate for Payer: UnitedHealthcare Community & State	$5.31
Rate for Payer: Wellpoint Medicaid Managed Care	$5.84

TUBE GASTROSTOMY MIC 18FR

Facility

$220.30

Hospital Charge Code	270669889N
Hospital Revenue Code	272
Min. Negotiated Rate	$5.31
Max. Negotiated Rate	$110.15
Rate for Payer: Aetna Commercial	$83.71
Rate for Payer: Aetna Medicare Advantage	$66.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.18
Rate for Payer: Cigna Commercial	$110.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.09
Rate for Payer: Oxford Commercial	$44.06
Rate for Payer: Qualcare PPO/HMO/WC	$33.05
Rate for Payer: UnitedHealthcare Commercial	$44.06
Rate for Payer: UnitedHealthcare Community & State	$5.31
Rate for Payer: Wellpoint Medicaid Managed Care	$5.84

TUBE GASTROSTOMY MIC 18FR

Facility

$220.30

Hospital Charge Code	270669889S
Hospital Revenue Code	272
Min. Negotiated Rate	$33.05
Max. Negotiated Rate	$33.05
Rate for Payer: Qualcare PPO/HMO/WC	$33.05

TUBE GASTROSTOMY MIC 18FR

Facility

$873.00

Hospital Charge Code	270661988S
Hospital Revenue Code	272
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) PPO	$222.62
Rate for Payer: Cigna Commercial	$436.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.90
Rate for Payer: Oxford Commercial	$174.60
Rate for Payer: Qualcare PPO/HMO/WC	$130.95
Rate for Payer: UnitedHealthcare Commercial	$174.60
Rate for Payer: UnitedHealthcare Community & State	$21.04
Rate for Payer: Wellpoint Medicaid Managed Care	$23.13

TUBE GASTROSTOMY MIC 18FR

Facility

$152.45

Hospital Charge Code	270661988N
Hospital Revenue Code	272
Min. Negotiated Rate	$22.87
Max. Negotiated Rate	$22.87
Rate for Payer: Qualcare PPO/HMO/WC	$22.87

TUBE GASTROSTOMY MIC 18FR

Facility

$220.30

Hospital Charge Code	270669889
Hospital Revenue Code	272
Min. Negotiated Rate	$33.05
Max. Negotiated Rate	$33.05
Rate for Payer: Qualcare PPO/HMO/WC	$33.05

TUBE GASTROSTOMY MIC 18FR

Facility

$220.30

Hospital Charge Code	270669889N
Hospital Revenue Code	272
Min. Negotiated Rate	$33.05
Max. Negotiated Rate	$33.05
Rate for Payer: Qualcare PPO/HMO/WC	$33.05

Know your out-of-pocket cost for care.

All Charges