Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TUBE GASTROSTO REPLCMT***

Facility

$355.00

Hospital Charge Code	2300747
Hospital Revenue Code	279
Min. Negotiated Rate	$53.25
Max. Negotiated Rate	$53.25
Rate for Payer: Qualcare PPO/HMO/WC	$53.25

TUBE GASTROSTO REPLCMT***

Facility

$355.00

Hospital Charge Code	2300747
Hospital Revenue Code	279
Min. Negotiated Rate	$8.56
Max. Negotiated Rate	$177.50
Rate for Payer: Aetna Commercial	$134.90
Rate for Payer: Aetna Medicare Advantage	$106.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$90.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$90.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$90.53
Rate for Payer: Cigna Commercial	$177.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.50
Rate for Payer: Oxford Commercial	$71.00
Rate for Payer: Qualcare PPO/HMO/WC	$53.25
Rate for Payer: UnitedHealthcare Commercial	$71.00
Rate for Payer: UnitedHealthcare Community & State	$8.56
Rate for Payer: Wellpoint Medicaid Managed Care	$9.41

TUBE GASTROST TRI 20F 000720

Facility

$338.45

Hospital Charge Code	270604824
Hospital Revenue Code	272
Min. Negotiated Rate	$50.77
Max. Negotiated Rate	$50.77
Rate for Payer: Qualcare PPO/HMO/WC	$50.77

TUBE GASTROST TRI 20F 000720

Facility

$338.45

Hospital Charge Code	270604824
Hospital Revenue Code	272
Min. Negotiated Rate	$8.16
Max. Negotiated Rate	$169.22
Rate for Payer: Aetna Commercial	$128.61
Rate for Payer: Aetna Medicare Advantage	$101.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.30
Rate for Payer: Cigna Commercial	$169.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.53
Rate for Payer: Oxford Commercial	$67.69
Rate for Payer: Qualcare PPO/HMO/WC	$50.77
Rate for Payer: UnitedHealthcare Commercial	$67.69
Rate for Payer: UnitedHealthcare Community & State	$8.16
Rate for Payer: Wellpoint Medicaid Managed Care	$8.97

TUBE G FEEDING 14 FR

Facility

$112.50

Hospital Charge Code	270999004
Hospital Revenue Code	272
Min. Negotiated Rate	$2.71
Max. Negotiated Rate	$56.25
Rate for Payer: Aetna Commercial	$42.75
Rate for Payer: Aetna Medicare Advantage	$33.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.69
Rate for Payer: Cigna Commercial	$56.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.75
Rate for Payer: Oxford Commercial	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.88
Rate for Payer: UnitedHealthcare Commercial	$22.50
Rate for Payer: UnitedHealthcare Community & State	$2.71
Rate for Payer: Wellpoint Medicaid Managed Care	$2.98

TUBE G FEEDING 14 FR

Facility

$112.50

Hospital Charge Code	270999004
Hospital Revenue Code	272
Min. Negotiated Rate	$16.88
Max. Negotiated Rate	$16.88
Rate for Payer: Qualcare PPO/HMO/WC	$16.88

TUBE GOODE T MYRINGOTOMY

Facility

$188.00

Hospital Charge Code	270602892
Hospital Revenue Code	272
Min. Negotiated Rate	$28.20
Max. Negotiated Rate	$28.20
Rate for Payer: Qualcare PPO/HMO/WC	$28.20

TUBE GOODE T MYRINGOTOMY

Facility

$188.00

Hospital Charge Code	270602892
Hospital Revenue Code	272
Min. Negotiated Rate	$4.53
Max. Negotiated Rate	$94.00
Rate for Payer: Aetna Commercial	$71.44
Rate for Payer: Aetna Medicare Advantage	$56.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.94
Rate for Payer: Cigna Commercial	$94.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.40
Rate for Payer: Oxford Commercial	$37.60
Rate for Payer: Qualcare PPO/HMO/WC	$28.20
Rate for Payer: UnitedHealthcare Commercial	$37.60
Rate for Payer: UnitedHealthcare Community & State	$4.53
Rate for Payer: Wellpoint Medicaid Managed Care	$4.98

TUBE GRAFT KNITT STRAIGHT 6X60

Facility

$2,530.50

Hospital Charge Code	270664858
Hospital Revenue Code	270
Min. Negotiated Rate	$60.99
Max. Negotiated Rate	$1,265.25
Rate for Payer: Aetna Commercial	$961.59
Rate for Payer: Aetna Medicare Advantage	$759.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$645.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$645.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$645.28
Rate for Payer: Cigna Commercial	$1,265.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$759.15
Rate for Payer: Oxford Commercial	$506.10
Rate for Payer: Qualcare PPO/HMO/WC	$379.57
Rate for Payer: UnitedHealthcare Commercial	$506.10
Rate for Payer: UnitedHealthcare Community & State	$60.99
Rate for Payer: Wellpoint Medicaid Managed Care	$67.06

TUBE GRAFT KNITT STRAIGHT 6X60

Facility

$2,530.50

Hospital Charge Code	270664858
Hospital Revenue Code	270
Min. Negotiated Rate	$379.57
Max. Negotiated Rate	$379.57
Rate for Payer: Qualcare PPO/HMO/WC	$379.57

TUBE G REPL STR 18FR

Facility

$138.33

Hospital Charge Code	270656976
Hospital Revenue Code	272
Min. Negotiated Rate	$3.33
Max. Negotiated Rate	$69.17
Rate for Payer: Aetna Commercial	$52.57
Rate for Payer: Aetna Medicare Advantage	$41.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.27
Rate for Payer: Cigna Commercial	$69.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.50
Rate for Payer: Oxford Commercial	$27.67
Rate for Payer: Qualcare PPO/HMO/WC	$20.75
Rate for Payer: UnitedHealthcare Commercial	$27.67
Rate for Payer: UnitedHealthcare Community & State	$3.33
Rate for Payer: Wellpoint Medicaid Managed Care	$3.67

TUBE G REPL STR 18FR

Facility

$138.33

Hospital Charge Code	270656976
Hospital Revenue Code	272
Min. Negotiated Rate	$20.75
Max. Negotiated Rate	$20.75
Rate for Payer: Qualcare PPO/HMO/WC	$20.75

TUBE GSTRSTMY FLXFLO20FR 51364

Facility

$118.25

Hospital Charge Code	270302330
Hospital Revenue Code	272
Min. Negotiated Rate	$2.85
Max. Negotiated Rate	$59.12
Rate for Payer: Aetna Commercial	$44.94
Rate for Payer: Aetna Medicare Advantage	$35.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.15
Rate for Payer: Cigna Commercial	$59.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.48
Rate for Payer: Oxford Commercial	$23.65
Rate for Payer: Qualcare PPO/HMO/WC	$17.74
Rate for Payer: UnitedHealthcare Commercial	$23.65
Rate for Payer: UnitedHealthcare Community & State	$2.85
Rate for Payer: Wellpoint Medicaid Managed Care	$3.13

TUBE GSTRSTMY FLXFLO20FR 51364

Facility

$118.25

Hospital Charge Code	270302330
Hospital Revenue Code	272
Min. Negotiated Rate	$17.74
Max. Negotiated Rate	$17.74
Rate for Payer: Qualcare PPO/HMO/WC	$17.74

TUBE HI/LOW EVAC SZ 7

Facility

$179.96

Hospital Charge Code	270650103
Hospital Revenue Code	270
Min. Negotiated Rate	$26.99
Max. Negotiated Rate	$26.99
Rate for Payer: Qualcare PPO/HMO/WC	$26.99

TUBE HI/LOW EVAC SZ 7

Facility

$179.96

Hospital Charge Code	270650103
Hospital Revenue Code	270
Min. Negotiated Rate	$4.34
Max. Negotiated Rate	$89.98
Rate for Payer: Aetna Commercial	$68.38
Rate for Payer: Aetna Medicare Advantage	$53.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.89
Rate for Payer: Cigna Commercial	$89.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.99
Rate for Payer: Oxford Commercial	$35.99
Rate for Payer: Qualcare PPO/HMO/WC	$26.99
Rate for Payer: UnitedHealthcare Commercial	$35.99
Rate for Payer: UnitedHealthcare Community & State	$4.34
Rate for Payer: Wellpoint Medicaid Managed Care	$4.77

TUBE HI/LOW EVAC SZ 7.5

Facility

$179.96

Hospital Charge Code	270650102
Hospital Revenue Code	270
Min. Negotiated Rate	$4.34
Max. Negotiated Rate	$89.98
Rate for Payer: Aetna Commercial	$68.38
Rate for Payer: Aetna Medicare Advantage	$53.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.89
Rate for Payer: Cigna Commercial	$89.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.99
Rate for Payer: Oxford Commercial	$35.99
Rate for Payer: Qualcare PPO/HMO/WC	$26.99
Rate for Payer: UnitedHealthcare Commercial	$35.99
Rate for Payer: UnitedHealthcare Community & State	$4.34
Rate for Payer: Wellpoint Medicaid Managed Care	$4.77

TUBE HI/LOW EVAC SZ 7.5

Facility

$179.96

Hospital Charge Code	270650102
Hospital Revenue Code	270
Min. Negotiated Rate	$26.99
Max. Negotiated Rate	$26.99
Rate for Payer: Qualcare PPO/HMO/WC	$26.99

TUBE HI/LOW EVAC SZ 8

Facility

$179.96

Hospital Charge Code	270650104
Hospital Revenue Code	270
Min. Negotiated Rate	$4.34
Max. Negotiated Rate	$89.98
Rate for Payer: Aetna Commercial	$68.38
Rate for Payer: Aetna Medicare Advantage	$53.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.89
Rate for Payer: Cigna Commercial	$89.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.99
Rate for Payer: Oxford Commercial	$35.99
Rate for Payer: Qualcare PPO/HMO/WC	$26.99
Rate for Payer: UnitedHealthcare Commercial	$35.99
Rate for Payer: UnitedHealthcare Community & State	$4.34
Rate for Payer: Wellpoint Medicaid Managed Care	$4.77

TUBE HI/LOW EVAC SZ 8

Facility

$179.96

Hospital Charge Code	270650104
Hospital Revenue Code	270
Min. Negotiated Rate	$26.99
Max. Negotiated Rate	$26.99
Rate for Payer: Qualcare PPO/HMO/WC	$26.99

TUBE HI/LOW EVAC SZ 8.5

Facility

$203.14

Hospital Charge Code	270650105
Hospital Revenue Code	270
Min. Negotiated Rate	$30.47
Max. Negotiated Rate	$30.47
Rate for Payer: Qualcare PPO/HMO/WC	$30.47

TUBE HI/LOW EVAC SZ 8.5

Facility

$203.14

Hospital Charge Code	270650105
Hospital Revenue Code	270
Min. Negotiated Rate	$4.90
Max. Negotiated Rate	$101.57
Rate for Payer: Aetna Commercial	$77.19
Rate for Payer: Aetna Medicare Advantage	$60.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.80
Rate for Payer: Cigna Commercial	$101.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.94
Rate for Payer: Oxford Commercial	$40.63
Rate for Payer: Qualcare PPO/HMO/WC	$30.47
Rate for Payer: UnitedHealthcare Commercial	$40.63
Rate for Payer: UnitedHealthcare Community & State	$4.90
Rate for Payer: Wellpoint Medicaid Managed Care	$5.38

TUBE HI/LOW EVAC SZ 9

Facility

$121.64

Hospital Charge Code	270650106
Hospital Revenue Code	270
Min. Negotiated Rate	$2.93
Max. Negotiated Rate	$60.82
Rate for Payer: Aetna Commercial	$46.22
Rate for Payer: Aetna Medicare Advantage	$36.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.02
Rate for Payer: Cigna Commercial	$60.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.49
Rate for Payer: Oxford Commercial	$24.33
Rate for Payer: Qualcare PPO/HMO/WC	$18.25
Rate for Payer: UnitedHealthcare Commercial	$24.33
Rate for Payer: UnitedHealthcare Community & State	$2.93
Rate for Payer: Wellpoint Medicaid Managed Care	$3.22

TUBE HI/LOW EVAC SZ 9

Facility

$121.64

Hospital Charge Code	270650106
Hospital Revenue Code	270
Min. Negotiated Rate	$18.25
Max. Negotiated Rate	$18.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.25

TUBE, HI PRESSURE

Facility

$76.00

Hospital Charge Code	2008150
Hospital Revenue Code	272
Min. Negotiated Rate	$11.40
Max. Negotiated Rate	$11.40
Rate for Payer: Qualcare PPO/HMO/WC	$11.40

Know your out-of-pocket cost for care.

All Charges