Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TUBE MILLER ABBOTT 16FR***

Facility

$140.00

Hospital Charge Code	8001083
Hospital Revenue Code	279
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$70.00
Rate for Payer: Aetna Commercial	$53.20
Rate for Payer: Aetna Medicare Advantage	$42.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.70
Rate for Payer: Cigna Commercial	$70.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.00
Rate for Payer: Oxford Commercial	$28.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.00
Rate for Payer: UnitedHealthcare Commercial	$28.00
Rate for Payer: UnitedHealthcare Community & State	$3.37
Rate for Payer: Wellpoint Medicaid Managed Care	$3.71

TUBE MINNESOTA****

Facility

$344.00

Hospital Charge Code	8001075
Hospital Revenue Code	279
Min. Negotiated Rate	$8.29
Max. Negotiated Rate	$172.00
Rate for Payer: Aetna Commercial	$130.72
Rate for Payer: Aetna Medicare Advantage	$103.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.72
Rate for Payer: Cigna Commercial	$172.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.20
Rate for Payer: Oxford Commercial	$68.80
Rate for Payer: Qualcare PPO/HMO/WC	$51.60
Rate for Payer: UnitedHealthcare Commercial	$68.80
Rate for Payer: UnitedHealthcare Community & State	$8.29
Rate for Payer: Wellpoint Medicaid Managed Care	$9.12

TUBE MINNESOTA****

Facility

$344.00

Hospital Charge Code	8001075
Hospital Revenue Code	279
Min. Negotiated Rate	$51.60
Max. Negotiated Rate	$51.60
Rate for Payer: Qualcare PPO/HMO/WC	$51.60

TUBE MINNESOTA 4 LUMEN 18FR

Facility

$3,028.85

Hospital Charge Code	270607548
Hospital Revenue Code	270
Min. Negotiated Rate	$73.00
Max. Negotiated Rate	$1,514.42
Rate for Payer: Aetna Commercial	$1,150.96
Rate for Payer: Aetna Medicare Advantage	$908.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$772.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$772.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$772.36
Rate for Payer: Cigna Commercial	$1,514.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$908.65
Rate for Payer: Oxford Commercial	$605.77
Rate for Payer: Qualcare PPO/HMO/WC	$454.33
Rate for Payer: UnitedHealthcare Commercial	$605.77
Rate for Payer: UnitedHealthcare Community & State	$73.00
Rate for Payer: Wellpoint Medicaid Managed Care	$80.26

TUBE MINNESOTA 4 LUMEN 18FR

Facility

$3,028.85

Hospital Charge Code	270607548
Hospital Revenue Code	270
Min. Negotiated Rate	$454.33
Max. Negotiated Rate	$454.33
Rate for Payer: Qualcare PPO/HMO/WC	$454.33

TUBE MIRCO W/MICROGARD EDTA

Facility

$114.90

Hospital Charge Code	270663954
Hospital Revenue Code	270
Min. Negotiated Rate	$2.77
Max. Negotiated Rate	$57.45
Rate for Payer: Aetna Commercial	$43.66
Rate for Payer: Aetna Medicare Advantage	$34.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.30
Rate for Payer: Cigna Commercial	$57.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.47
Rate for Payer: Oxford Commercial	$22.98
Rate for Payer: Qualcare PPO/HMO/WC	$17.23
Rate for Payer: UnitedHealthcare Commercial	$22.98
Rate for Payer: UnitedHealthcare Community & State	$2.77
Rate for Payer: Wellpoint Medicaid Managed Care	$3.04

TUBE MIRCO W/MICROGARD EDTA

Facility

$114.90

Hospital Charge Code	270663954
Hospital Revenue Code	270
Min. Negotiated Rate	$17.23
Max. Negotiated Rate	$17.23
Rate for Payer: Qualcare PPO/HMO/WC	$17.23

TUBE MOSS GASTRO 18FR 18

Facility

$2,882.45

Hospital Charge Code	270605618
Hospital Revenue Code	272
Min. Negotiated Rate	$432.37
Max. Negotiated Rate	$432.37
Rate for Payer: Qualcare PPO/HMO/WC	$432.37

TUBE MOSS GASTRO 18FR 18

Facility

$2,882.45

Hospital Charge Code	270605618
Hospital Revenue Code	272
Min. Negotiated Rate	$69.47
Max. Negotiated Rate	$1,441.22
Rate for Payer: Aetna Commercial	$1,095.33
Rate for Payer: Aetna Medicare Advantage	$864.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$735.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$735.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$735.02
Rate for Payer: Cigna Commercial	$1,441.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$864.74
Rate for Payer: Oxford Commercial	$576.49
Rate for Payer: Qualcare PPO/HMO/WC	$432.37
Rate for Payer: UnitedHealthcare Commercial	$576.49
Rate for Payer: UnitedHealthcare Community & State	$69.47
Rate for Payer: Wellpoint Medicaid Managed Care	$76.38

TUBE MOSS GASTROST 5-17722****

Facility

$1,171.00

Hospital Charge Code	1604388
Hospital Revenue Code	272
Min. Negotiated Rate	$28.22
Max. Negotiated Rate	$585.50
Rate for Payer: Aetna Commercial	$444.98
Rate for Payer: Aetna Medicare Advantage	$351.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$298.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$298.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$298.61
Rate for Payer: Cigna Commercial	$585.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$351.30
Rate for Payer: Oxford Commercial	$234.20
Rate for Payer: Qualcare PPO/HMO/WC	$175.65
Rate for Payer: UnitedHealthcare Commercial	$234.20
Rate for Payer: UnitedHealthcare Community & State	$28.22
Rate for Payer: Wellpoint Medicaid Managed Care	$31.03

TUBE MOSS GASTROST 5-17722****

Facility

$1,171.00

Hospital Charge Code	1604388
Hospital Revenue Code	272
Min. Negotiated Rate	$175.65
Max. Negotiated Rate	$175.65
Rate for Payer: Qualcare PPO/HMO/WC	$175.65

TUBE MYRINGOTOMY STR SHANK FLU

Facility

$176.00

Hospital Charge Code	270655886
Hospital Revenue Code	271
Min. Negotiated Rate	$26.40
Max. Negotiated Rate	$26.40
Rate for Payer: Qualcare PPO/HMO/WC	$26.40

TUBE MYRINGOTOMY STR SHANK FLU

Facility

$176.00

Hospital Charge Code	270655886
Hospital Revenue Code	271
Min. Negotiated Rate	$4.24
Max. Negotiated Rate	$88.00
Rate for Payer: Aetna Commercial	$66.88
Rate for Payer: Aetna Medicare Advantage	$52.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.88
Rate for Payer: Cigna Commercial	$88.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.80
Rate for Payer: Oxford Commercial	$35.20
Rate for Payer: Qualcare PPO/HMO/WC	$26.40
Rate for Payer: UnitedHealthcare Commercial	$35.20
Rate for Payer: UnitedHealthcare Community & State	$4.24
Rate for Payer: Wellpoint Medicaid Managed Care	$4.66

TUBE NASAL MARK IV87167 MOSS**

Facility

$972.00

Hospital Charge Code	1604396
Hospital Revenue Code	272
Min. Negotiated Rate	$145.80
Max. Negotiated Rate	$145.80
Rate for Payer: Qualcare PPO/HMO/WC	$145.80

TUBE NASAL MARK IV87167 MOSS**

Facility

$972.00

Hospital Charge Code	1604396
Hospital Revenue Code	272
Min. Negotiated Rate	$23.43
Max. Negotiated Rate	$486.00
Rate for Payer: Aetna Commercial	$369.36
Rate for Payer: Aetna Medicare Advantage	$291.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$247.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$247.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$247.86
Rate for Payer: Cigna Commercial	$486.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.60
Rate for Payer: Oxford Commercial	$194.40
Rate for Payer: Qualcare PPO/HMO/WC	$145.80
Rate for Payer: UnitedHealthcare Commercial	$194.40
Rate for Payer: UnitedHealthcare Community & State	$23.43
Rate for Payer: Wellpoint Medicaid Managed Care	$25.76

TUBE NASAL RAE ENDOTRACH 6.0

Facility

$23.55

Hospital Charge Code	270677053
Hospital Revenue Code	272
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$11.78
Rate for Payer: Aetna Commercial	$8.95
Rate for Payer: Aetna Medicare Advantage	$7.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.01
Rate for Payer: Cigna Commercial	$11.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.07
Rate for Payer: Oxford Commercial	$4.71
Rate for Payer: Qualcare PPO/HMO/WC	$3.53
Rate for Payer: UnitedHealthcare Commercial	$4.71
Rate for Payer: UnitedHealthcare Community & State	$0.57
Rate for Payer: Wellpoint Medicaid Managed Care	$0.62

TUBE NASAL RAE ENDOTRACH 6.0

Facility

$23.55

Hospital Charge Code	270677053
Hospital Revenue Code	272
Min. Negotiated Rate	$3.53
Max. Negotiated Rate	$3.53
Rate for Payer: Qualcare PPO/HMO/WC	$3.53

TUBE NASAL RAE ENDOTRACH 6.5

Facility

$23.55

Hospital Charge Code	270677054
Hospital Revenue Code	272
Min. Negotiated Rate	$3.53
Max. Negotiated Rate	$3.53
Rate for Payer: Qualcare PPO/HMO/WC	$3.53

TUBE NASAL RAE ENDOTRACH 6.5

Facility

$23.55

Hospital Charge Code	270677054
Hospital Revenue Code	272
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$11.78
Rate for Payer: Aetna Commercial	$8.95
Rate for Payer: Aetna Medicare Advantage	$7.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.01
Rate for Payer: Cigna Commercial	$11.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.07
Rate for Payer: Oxford Commercial	$4.71
Rate for Payer: Qualcare PPO/HMO/WC	$3.53
Rate for Payer: UnitedHealthcare Commercial	$4.71
Rate for Payer: UnitedHealthcare Community & State	$0.57
Rate for Payer: Wellpoint Medicaid Managed Care	$0.62

TUBE NASAL RAE ENDOTRACH 7.0

Facility

$235.75

Hospital Charge Code	270677055
Hospital Revenue Code	272
Min. Negotiated Rate	$35.36
Max. Negotiated Rate	$35.36
Rate for Payer: Qualcare PPO/HMO/WC	$35.36

TUBE NASAL RAE ENDOTRACH 7.0

Facility

$235.75

Hospital Charge Code	270677055
Hospital Revenue Code	272
Min. Negotiated Rate	$5.68
Max. Negotiated Rate	$117.88
Rate for Payer: Aetna Commercial	$89.58
Rate for Payer: Aetna Medicare Advantage	$70.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.12
Rate for Payer: Cigna Commercial	$117.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.72
Rate for Payer: Oxford Commercial	$47.15
Rate for Payer: Qualcare PPO/HMO/WC	$35.36
Rate for Payer: UnitedHealthcare Commercial	$47.15
Rate for Payer: UnitedHealthcare Community & State	$5.68
Rate for Payer: Wellpoint Medicaid Managed Care	$6.25

TUBE NASAL RAE ENDOTRACH 7.5

Facility

$23.55

Hospital Charge Code	270677056
Hospital Revenue Code	272
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$11.78
Rate for Payer: Aetna Commercial	$8.95
Rate for Payer: Aetna Medicare Advantage	$7.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.01
Rate for Payer: Cigna Commercial	$11.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.07
Rate for Payer: Oxford Commercial	$4.71
Rate for Payer: Qualcare PPO/HMO/WC	$3.53
Rate for Payer: UnitedHealthcare Commercial	$4.71
Rate for Payer: UnitedHealthcare Community & State	$0.57
Rate for Payer: Wellpoint Medicaid Managed Care	$0.62

TUBE NASAL RAE ENDOTRACH 7.5

Facility

$23.55

Hospital Charge Code	270677056
Hospital Revenue Code	272
Min. Negotiated Rate	$3.53
Max. Negotiated Rate	$3.53
Rate for Payer: Qualcare PPO/HMO/WC	$3.53

TUBE NASAL RAE ENDOTRACH 8.0

Facility

$235.75

Hospital Charge Code	270677057
Hospital Revenue Code	272
Min. Negotiated Rate	$35.36
Max. Negotiated Rate	$35.36
Rate for Payer: Qualcare PPO/HMO/WC	$35.36

TUBE NASAL RAE ENDOTRACH 8.0

Facility

$235.75

Hospital Charge Code	270677057
Hospital Revenue Code	272
Min. Negotiated Rate	$5.68
Max. Negotiated Rate	$117.88
Rate for Payer: Aetna Commercial	$89.58
Rate for Payer: Aetna Medicare Advantage	$70.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.12
Rate for Payer: Cigna Commercial	$117.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.72
Rate for Payer: Oxford Commercial	$47.15
Rate for Payer: Qualcare PPO/HMO/WC	$35.36
Rate for Payer: UnitedHealthcare Commercial	$47.15
Rate for Payer: UnitedHealthcare Community & State	$5.68
Rate for Payer: Wellpoint Medicaid Managed Care	$6.25

Know your out-of-pocket cost for care.

All Charges