Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TUBE LIFE SAVING ADULT HUDSON

Facility

$4.34

Hospital Charge Code	270649929
Hospital Revenue Code	270
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.17
Rate for Payer: Aetna Commercial	$1.65
Rate for Payer: Aetna Medicare Advantage	$1.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.11
Rate for Payer: Cigna Commercial	$2.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.30
Rate for Payer: Oxford Commercial	$0.87
Rate for Payer: Qualcare PPO/HMO/WC	$0.65
Rate for Payer: UnitedHealthcare Commercial	$0.87
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.12

TUBE LIFE SAVING ADULT HUDSON

Facility

$4.34

Hospital Charge Code	270649929
Hospital Revenue Code	270
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$0.65
Rate for Payer: Qualcare PPO/HMO/WC	$0.65

TUBE LSR SHLD II 5.5MM 7060250

Facility

$868.75

Hospital Charge Code	270607058
Hospital Revenue Code	272
Min. Negotiated Rate	$20.94
Max. Negotiated Rate	$434.38
Rate for Payer: Aetna Commercial	$330.12
Rate for Payer: Aetna Medicare Advantage	$260.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$221.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$221.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$221.53
Rate for Payer: Cigna Commercial	$434.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.62
Rate for Payer: Oxford Commercial	$173.75
Rate for Payer: Qualcare PPO/HMO/WC	$130.31
Rate for Payer: UnitedHealthcare Commercial	$173.75
Rate for Payer: UnitedHealthcare Community & State	$20.94
Rate for Payer: Wellpoint Medicaid Managed Care	$23.02

TUBE LSR SHLD II 5.5MM 7060250

Facility

$868.75

Hospital Charge Code	270607058
Hospital Revenue Code	272
Min. Negotiated Rate	$130.31
Max. Negotiated Rate	$130.31
Rate for Payer: Qualcare PPO/HMO/WC	$130.31

TUBE MCV FEEDING JEJ 12F 6643

Facility

$503.25

Hospital Charge Code	270620419
Hospital Revenue Code	272
Min. Negotiated Rate	$12.13
Max. Negotiated Rate	$251.62
Rate for Payer: Aetna Commercial	$191.24
Rate for Payer: Aetna Medicare Advantage	$150.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.33
Rate for Payer: Cigna Commercial	$251.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.97
Rate for Payer: Oxford Commercial	$100.65
Rate for Payer: Qualcare PPO/HMO/WC	$75.49
Rate for Payer: UnitedHealthcare Commercial	$100.65
Rate for Payer: UnitedHealthcare Community & State	$12.13
Rate for Payer: Wellpoint Medicaid Managed Care	$13.34

TUBE MCV FEEDING JEJ 12F 6643

Facility

$503.25

Hospital Charge Code	270620419
Hospital Revenue Code	272
Min. Negotiated Rate	$75.49
Max. Negotiated Rate	$75.49
Rate for Payer: Qualcare PPO/HMO/WC	$75.49

TUBE MCV GASTROST REPLC 6220

Facility

$195.00

Hospital Charge Code	270614167
Hospital Revenue Code	272
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$29.25
Rate for Payer: Qualcare PPO/HMO/WC	$29.25

TUBE MCV GASTROST REPLC 6220

Facility

$195.00

Hospital Charge Code	270614167
Hospital Revenue Code	272
Min. Negotiated Rate	$4.70
Max. Negotiated Rate	$97.50
Rate for Payer: Aetna Commercial	$74.10
Rate for Payer: Aetna Medicare Advantage	$58.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.73
Rate for Payer: Cigna Commercial	$97.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.50
Rate for Payer: Oxford Commercial	$39.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.25
Rate for Payer: UnitedHealthcare Commercial	$39.00
Rate for Payer: UnitedHealthcare Community & State	$4.70
Rate for Payer: Wellpoint Medicaid Managed Care	$5.17

TUBE MEDULLARY 35501

Facility

$364.65

Hospital Charge Code	270633856
Hospital Revenue Code	272
Min. Negotiated Rate	$54.70
Max. Negotiated Rate	$54.70
Rate for Payer: Qualcare PPO/HMO/WC	$54.70

TUBE MEDULLARY 35501

Facility

$364.65

Hospital Charge Code	270633856
Hospital Revenue Code	272
Min. Negotiated Rate	$8.79
Max. Negotiated Rate	$182.32
Rate for Payer: Aetna Commercial	$138.57
Rate for Payer: Aetna Medicare Advantage	$109.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.99
Rate for Payer: Cigna Commercial	$182.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.39
Rate for Payer: Oxford Commercial	$72.93
Rate for Payer: Qualcare PPO/HMO/WC	$54.70
Rate for Payer: UnitedHealthcare Commercial	$72.93
Rate for Payer: UnitedHealthcare Community & State	$8.79
Rate for Payer: Wellpoint Medicaid Managed Care	$9.66

TUBE MEDULLRY ALIGN 6.3 469395

Facility

$230.00

Hospital Charge Code	270632876
Hospital Revenue Code	272
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$115.00
Rate for Payer: Aetna Commercial	$87.40
Rate for Payer: Aetna Medicare Advantage	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.65
Rate for Payer: Cigna Commercial	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.00
Rate for Payer: Oxford Commercial	$46.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.50
Rate for Payer: UnitedHealthcare Commercial	$46.00
Rate for Payer: UnitedHealthcare Community & State	$5.54
Rate for Payer: Wellpoint Medicaid Managed Care	$6.09

TUBE MEDULLRY ALIGN 6.3 469395

Facility

$230.00

Hospital Charge Code	270632876
Hospital Revenue Code	272
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$34.50
Rate for Payer: Qualcare PPO/HMO/WC	$34.50

TUBE MIC GASTROSTOMY ADULT 20

Facility

$220.30

Hospital Charge Code	270666073
Hospital Revenue Code	272
Min. Negotiated Rate	$33.05
Max. Negotiated Rate	$33.05
Rate for Payer: Qualcare PPO/HMO/WC	$33.05

TUBE MIC GASTROSTOMY ADULT 20

Facility

$220.30

Hospital Charge Code	270666073
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 MIC GASTROSTOMY FEED 16FR

Facility

$220.30

Hospital Charge Code	672029
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 MIC GASTROSTOMY FEED 16FR

Facility

$220.30

Hospital Charge Code	672029
Hospital Revenue Code	272
Min. Negotiated Rate	$33.05
Max. Negotiated Rate	$33.05
Rate for Payer: Qualcare PPO/HMO/WC	$33.05

TUBE MIC-KEY GASTRO 16FR 4.0cm

Facility

$512.20

Hospital Charge Code	270672280
Hospital Revenue Code	272
Min. Negotiated Rate	$76.83
Max. Negotiated Rate	$76.83
Rate for Payer: Qualcare PPO/HMO/WC	$76.83

TUBE MIC-KEY GASTRO 16FR 4.0cm

Facility

$512.20

Hospital Charge Code	270672280
Hospital Revenue Code	272
Min. Negotiated Rate	$12.34
Max. Negotiated Rate	$256.10
Rate for Payer: Aetna Commercial	$194.64
Rate for Payer: Aetna Medicare Advantage	$153.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.61
Rate for Payer: Cigna Commercial	$256.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.66
Rate for Payer: Oxford Commercial	$102.44
Rate for Payer: Qualcare PPO/HMO/WC	$76.83
Rate for Payer: UnitedHealthcare Commercial	$102.44
Rate for Payer: UnitedHealthcare Community & State	$12.34
Rate for Payer: Wellpoint Medicaid Managed Care	$13.57

TUBE MIC-KEY GASTRO 18FR 4.0cm

Facility

$841.20

Hospital Charge Code	270672281
Hospital Revenue Code	272
Min. Negotiated Rate	$126.18
Max. Negotiated Rate	$126.18
Rate for Payer: Qualcare PPO/HMO/WC	$126.18

TUBE MIC-KEY GASTRO 18FR 4.0cm

Facility

$841.20

Hospital Charge Code	270672281
Hospital Revenue Code	272
Min. Negotiated Rate	$20.27
Max. Negotiated Rate	$420.60
Rate for Payer: Aetna Commercial	$319.66
Rate for Payer: Aetna Medicare Advantage	$252.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$214.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$214.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$214.51
Rate for Payer: Cigna Commercial	$420.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$252.36
Rate for Payer: Oxford Commercial	$168.24
Rate for Payer: Qualcare PPO/HMO/WC	$126.18
Rate for Payer: UnitedHealthcare Commercial	$168.24
Rate for Payer: UnitedHealthcare Community & State	$20.27
Rate for Payer: Wellpoint Medicaid Managed Care	$22.29

TUBE MICKY G 20FX4 0 01202040

Facility

$540.75

Hospital Charge Code	270637752
Hospital Revenue Code	272
Min. Negotiated Rate	$13.03
Max. Negotiated Rate	$270.38
Rate for Payer: Aetna Commercial	$205.49
Rate for Payer: Aetna Medicare Advantage	$162.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$137.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$137.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$137.89
Rate for Payer: Cigna Commercial	$270.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.22
Rate for Payer: Oxford Commercial	$108.15
Rate for Payer: Qualcare PPO/HMO/WC	$81.11
Rate for Payer: UnitedHealthcare Commercial	$108.15
Rate for Payer: UnitedHealthcare Community & State	$13.03
Rate for Payer: Wellpoint Medicaid Managed Care	$14.33

TUBE MICKY G 20FX4 0 01202040

Facility

$540.75

Hospital Charge Code	270637752
Hospital Revenue Code	272
Min. Negotiated Rate	$81.11
Max. Negotiated Rate	$81.11
Rate for Payer: Qualcare PPO/HMO/WC	$81.11

TUBE MILLER ABBOTT 16FR

Facility

$651.25

Hospital Charge Code	270606390
Hospital Revenue Code	272
Min. Negotiated Rate	$97.69
Max. Negotiated Rate	$97.69
Rate for Payer: Qualcare PPO/HMO/WC	$97.69

TUBE MILLER ABBOTT 16FR

Facility

$651.25

Hospital Charge Code	270606390
Hospital Revenue Code	272
Min. Negotiated Rate	$15.70
Max. Negotiated Rate	$325.62
Rate for Payer: Aetna Commercial	$247.47
Rate for Payer: Aetna Medicare Advantage	$195.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$166.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$166.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$166.07
Rate for Payer: Cigna Commercial	$325.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.38
Rate for Payer: Oxford Commercial	$130.25
Rate for Payer: Qualcare PPO/HMO/WC	$97.69
Rate for Payer: UnitedHealthcare Commercial	$130.25
Rate for Payer: UnitedHealthcare Community & State	$15.70
Rate for Payer: Wellpoint Medicaid Managed Care	$17.26

TUBE MILLER ABBOTT 16FR***

Facility

$140.00

Hospital Charge Code	8001083
Hospital Revenue Code	279
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$21.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.00

Know your out-of-pocket cost for care.

All Charges