Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TUBE, HI PRESSURE

Facility

$76.00

Hospital Charge Code	2008150
Hospital Revenue Code	272
Min. Negotiated Rate	$1.83
Max. Negotiated Rate	$38.00
Rate for Payer: Aetna Commercial	$28.88
Rate for Payer: Aetna Medicare Advantage	$22.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.38
Rate for Payer: Cigna Commercial	$38.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.80
Rate for Payer: Oxford Commercial	$15.20
Rate for Payer: Qualcare PPO/HMO/WC	$11.40
Rate for Payer: UnitedHealthcare Commercial	$15.20
Rate for Payer: UnitedHealthcare Community & State	$1.83
Rate for Payer: Wellpoint Medicaid Managed Care	$2.01

TUBE HMD EXCH 0217-0-012

Facility

$1,058.45

Hospital Charge Code	270617158
Hospital Revenue Code	272
Min. Negotiated Rate	$25.51
Max. Negotiated Rate	$529.23
Rate for Payer: Aetna Commercial	$402.21
Rate for Payer: Aetna Medicare Advantage	$317.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$269.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$269.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$269.90
Rate for Payer: Cigna Commercial	$529.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$317.54
Rate for Payer: Oxford Commercial	$211.69
Rate for Payer: Qualcare PPO/HMO/WC	$158.77
Rate for Payer: UnitedHealthcare Commercial	$211.69
Rate for Payer: UnitedHealthcare Community & State	$25.51
Rate for Payer: Wellpoint Medicaid Managed Care	$28.05

TUBE HMD EXCH 0217-0-012

Facility

$1,058.45

Hospital Charge Code	270617158
Hospital Revenue Code	272
Min. Negotiated Rate	$158.77
Max. Negotiated Rate	$158.77
Rate for Payer: Qualcare PPO/HMO/WC	$158.77

TUBE INFLOW HYSTEROSCOPIC

Facility

$1,555.05

Hospital Charge Code	270700291
Hospital Revenue Code	272
Min. Negotiated Rate	$233.26
Max. Negotiated Rate	$233.26
Rate for Payer: Qualcare PPO/HMO/WC	$233.26

TUBE INFLOW HYSTEROSCOPIC

Facility

$1,555.05

Hospital Charge Code	270700291
Hospital Revenue Code	272
Min. Negotiated Rate	$37.48
Max. Negotiated Rate	$777.52
Rate for Payer: Aetna Commercial	$590.92
Rate for Payer: Aetna Medicare Advantage	$466.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$396.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$396.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$396.54
Rate for Payer: Cigna Commercial	$777.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$466.51
Rate for Payer: Oxford Commercial	$311.01
Rate for Payer: Qualcare PPO/HMO/WC	$233.26
Rate for Payer: UnitedHealthcare Commercial	$311.01
Rate for Payer: UnitedHealthcare Community & State	$37.48
Rate for Payer: Wellpoint Medicaid Managed Care	$41.21

TUBE INJECTION

Facility

$695.05

Hospital Charge Code	270677429
Hospital Revenue Code	272
Min. Negotiated Rate	$16.75
Max. Negotiated Rate	$347.52
Rate for Payer: Aetna Commercial	$264.12
Rate for Payer: Aetna Medicare Advantage	$208.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.24
Rate for Payer: Cigna Commercial	$347.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.51
Rate for Payer: Oxford Commercial	$139.01
Rate for Payer: Qualcare PPO/HMO/WC	$104.26
Rate for Payer: UnitedHealthcare Commercial	$139.01
Rate for Payer: UnitedHealthcare Community & State	$16.75
Rate for Payer: Wellpoint Medicaid Managed Care	$18.42

TUBE INJECTION

Facility

$695.05

Hospital Charge Code	270677429
Hospital Revenue Code	272
Min. Negotiated Rate	$104.26
Max. Negotiated Rate	$104.26
Rate for Payer: Qualcare PPO/HMO/WC	$104.26

TUBE INNER CANNULA TRACH4 4DIC

Facility

$13.58

Hospital Charge Code	270302425
Hospital Revenue Code	272
Min. Negotiated Rate	$2.04
Max. Negotiated Rate	$2.04
Rate for Payer: Qualcare PPO/HMO/WC	$2.04

TUBE INNER CANNULA TRACH4 4DIC

Facility

$13.58

Hospital Charge Code	270302425
Hospital Revenue Code	272
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$6.79
Rate for Payer: Aetna Commercial	$5.16
Rate for Payer: Aetna Medicare Advantage	$4.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.46
Rate for Payer: Cigna Commercial	$6.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.07
Rate for Payer: Oxford Commercial	$2.72
Rate for Payer: Qualcare PPO/HMO/WC	$2.04
Rate for Payer: UnitedHealthcare Commercial	$2.72
Rate for Payer: UnitedHealthcare Community & State	$0.33
Rate for Payer: Wellpoint Medicaid Managed Care	$0.36

TUBE INNER CANNULA TRACH 4DIC

Facility

$17.50

Hospital Charge Code	270602425
Hospital Revenue Code	270
Min. Negotiated Rate	$2.62
Max. Negotiated Rate	$2.62
Rate for Payer: Qualcare PPO/HMO/WC	$2.62

TUBE INNER CANNULA TRACH 4DIC

Facility

$17.50

Hospital Charge Code	270602425
Hospital Revenue Code	270
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$8.75
Rate for Payer: Aetna Commercial	$6.65
Rate for Payer: Aetna Medicare Advantage	$5.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.46
Rate for Payer: Cigna Commercial	$8.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.25
Rate for Payer: Oxford Commercial	$3.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.62
Rate for Payer: UnitedHealthcare Commercial	$3.50
Rate for Payer: UnitedHealthcare Community & State	$0.42
Rate for Payer: Wellpoint Medicaid Managed Care	$0.46

TUBE INNER CANNULA TRACH 6DIC

Facility

$19.30

Hospital Charge Code	270302426
Hospital Revenue Code	272
Min. Negotiated Rate	$0.47
Max. Negotiated Rate	$9.65
Rate for Payer: Aetna Commercial	$7.33
Rate for Payer: Aetna Medicare Advantage	$5.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.92
Rate for Payer: Cigna Commercial	$9.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.79
Rate for Payer: Oxford Commercial	$3.86
Rate for Payer: Qualcare PPO/HMO/WC	$2.90
Rate for Payer: UnitedHealthcare Commercial	$3.86
Rate for Payer: UnitedHealthcare Community & State	$0.47
Rate for Payer: Wellpoint Medicaid Managed Care	$0.51

TUBE INNER CANNULA TRACH 6DIC

Facility

$19.30

Hospital Charge Code	270302426
Hospital Revenue Code	272
Min. Negotiated Rate	$2.90
Max. Negotiated Rate	$2.90
Rate for Payer: Qualcare PPO/HMO/WC	$2.90

TUBE INTUBATION SET LAC LIS27T

Facility

$735.00

Hospital Charge Code	270641487
Hospital Revenue Code	272
Min. Negotiated Rate	$110.25
Max. Negotiated Rate	$110.25
Rate for Payer: Qualcare PPO/HMO/WC	$110.25

TUBE INTUBATION SET LAC LIS27T

Facility

$735.00

Hospital Charge Code	270641487
Hospital Revenue Code	272
Min. Negotiated Rate	$17.71
Max. Negotiated Rate	$367.50
Rate for Payer: Aetna Commercial	$279.30
Rate for Payer: Aetna Medicare Advantage	$220.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$187.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$187.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$187.43
Rate for Payer: Cigna Commercial	$367.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.50
Rate for Payer: Oxford Commercial	$147.00
Rate for Payer: Qualcare PPO/HMO/WC	$110.25
Rate for Payer: UnitedHealthcare Commercial	$147.00
Rate for Payer: UnitedHealthcare Community & State	$17.71
Rate for Payer: Wellpoint Medicaid Managed Care	$19.48

TUBE IRRIGATION

Facility

$375.00

Hospital Charge Code	270688485
Hospital Revenue Code	272
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.50
Rate for Payer: Oxford Commercial	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Commercial	$75.00
Rate for Payer: UnitedHealthcare Community & State	$9.04
Rate for Payer: Wellpoint Medicaid Managed Care	$9.94

TUBE IRRIGATION

Facility

$375.00

Hospital Charge Code	270688533
Hospital Revenue Code	272
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.50
Rate for Payer: Oxford Commercial	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Commercial	$75.00
Rate for Payer: UnitedHealthcare Community & State	$9.04
Rate for Payer: Wellpoint Medicaid Managed Care	$9.94

TUBE IRRIGATION

Facility

$375.00

Hospital Charge Code	270688533
Hospital Revenue Code	272
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

TUBE IRRIGATION

Facility

$375.00

Hospital Charge Code	270688485
Hospital Revenue Code	272
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

TUBE IRRIGATION*****

Facility

$220.00

Hospital Charge Code	27060478
Hospital Revenue Code	279
Min. Negotiated Rate	$5.30
Max. Negotiated Rate	$110.00
Rate for Payer: Aetna Commercial	$83.60
Rate for Payer: Aetna Medicare Advantage	$66.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.10
Rate for Payer: Cigna Commercial	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.00
Rate for Payer: Oxford Commercial	$44.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.00
Rate for Payer: UnitedHealthcare Commercial	$44.00
Rate for Payer: UnitedHealthcare Community & State	$5.30
Rate for Payer: Wellpoint Medicaid Managed Care	$5.83

TUBE IRRIGATION*****

Facility

$220.00

Hospital Charge Code	27060478
Hospital Revenue Code	279
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$33.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.00

TUBE IRRIGATION PENTAX 0F-B113

Facility

$562.45

Hospital Charge Code	270604788
Hospital Revenue Code	270
Min. Negotiated Rate	$84.37
Max. Negotiated Rate	$84.37
Rate for Payer: Qualcare PPO/HMO/WC	$84.37

TUBE IRRIGATION PENTAX 0F-B113

Facility

$562.45

Hospital Charge Code	270604788
Hospital Revenue Code	270
Min. Negotiated Rate	$13.56
Max. Negotiated Rate	$281.23
Rate for Payer: Aetna Commercial	$213.73
Rate for Payer: Aetna Medicare Advantage	$168.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$143.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$143.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$143.42
Rate for Payer: Cigna Commercial	$281.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.74
Rate for Payer: Oxford Commercial	$112.49
Rate for Payer: Qualcare PPO/HMO/WC	$84.37
Rate for Payer: UnitedHealthcare Commercial	$112.49
Rate for Payer: UnitedHealthcare Community & State	$13.56
Rate for Payer: Wellpoint Medicaid Managed Care	$14.90

TUBE IRRIGATION PENTAX 0F-B72

Facility

$562.45

Hospital Charge Code	270601169
Hospital Revenue Code	270
Min. Negotiated Rate	$13.56
Max. Negotiated Rate	$281.23
Rate for Payer: Aetna Commercial	$213.73
Rate for Payer: Aetna Medicare Advantage	$168.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$143.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$143.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$143.42
Rate for Payer: Cigna Commercial	$281.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.74
Rate for Payer: Oxford Commercial	$112.49
Rate for Payer: Qualcare PPO/HMO/WC	$84.37
Rate for Payer: UnitedHealthcare Commercial	$112.49
Rate for Payer: UnitedHealthcare Community & State	$13.56
Rate for Payer: Wellpoint Medicaid Managed Care	$14.90

TUBE IRRIGATION PENTAX 0F-B72

Facility

$562.45

Hospital Charge Code	270601169
Hospital Revenue Code	270
Min. Negotiated Rate	$84.37
Max. Negotiated Rate	$84.37
Rate for Payer: Qualcare PPO/HMO/WC	$84.37

Know your out-of-pocket cost for care.

All Charges