Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TUBE NONCONDUCT 20FR N620A

Facility

$6.16

Hospital Charge Code	270100764
Hospital Revenue Code	272
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$0.92
Rate for Payer: Qualcare PPO/HMO/WC	$0.92

TUBE NONCONDUCT 20FR N620A

Facility

$6.16

Hospital Charge Code	270100764
Hospital Revenue Code	272
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$3.08
Rate for Payer: Aetna Commercial	$2.34
Rate for Payer: Aetna Medicare Advantage	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.57
Rate for Payer: Cigna Commercial	$3.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.85
Rate for Payer: Oxford Commercial	$1.23
Rate for Payer: Qualcare PPO/HMO/WC	$0.92
Rate for Payer: UnitedHealthcare Commercial	$1.23
Rate for Payer: UnitedHealthcare Community & State	$0.15
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

TUBE NONCONDUCT CONNECT 1/4X6'

Facility

$2.32

Hospital Charge Code	270649310
Hospital Revenue Code	272
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.35
Rate for Payer: Qualcare PPO/HMO/WC	$0.35

TUBE NONCONDUCT CONNECT 1/4X6'

Facility

$2.32

Hospital Charge Code	270649310
Hospital Revenue Code	272
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$1.16
Rate for Payer: Aetna Commercial	$0.88
Rate for Payer: Aetna Medicare Advantage	$0.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.59
Rate for Payer: Cigna Commercial	$1.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.70
Rate for Payer: Oxford Commercial	$0.46
Rate for Payer: Qualcare PPO/HMO/WC	$0.35
Rate for Payer: UnitedHealthcare Commercial	$0.46
Rate for Payer: UnitedHealthcare Community & State	$0.06
Rate for Payer: Wellpoint Medicaid Managed Care	$0.06

TUBE NON CONDUCTIVE 20

Facility

$2.32

Hospital Charge Code	270654182
Hospital Revenue Code	270
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$1.16
Rate for Payer: Aetna Commercial	$0.88
Rate for Payer: Aetna Medicare Advantage	$0.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.59
Rate for Payer: Cigna Commercial	$1.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.70
Rate for Payer: Oxford Commercial	$0.46
Rate for Payer: Qualcare PPO/HMO/WC	$0.35
Rate for Payer: UnitedHealthcare Commercial	$0.46
Rate for Payer: UnitedHealthcare Community & State	$0.06
Rate for Payer: Wellpoint Medicaid Managed Care	$0.06

TUBE NON CONDUCTIVE 20

Facility

$2.32

Hospital Charge Code	270654182
Hospital Revenue Code	270
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.35
Rate for Payer: Qualcare PPO/HMO/WC	$0.35

TUBE NUPREP 4oz

Facility

$38.20

Hospital Charge Code	270620570
Hospital Revenue Code	272
Min. Negotiated Rate	$5.73
Max. Negotiated Rate	$5.73
Rate for Payer: Qualcare PPO/HMO/WC	$5.73

TUBE NUPREP 4oz

Facility

$38.20

Hospital Charge Code	270620570
Hospital Revenue Code	272
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$19.10
Rate for Payer: Aetna Commercial	$14.52
Rate for Payer: Aetna Medicare Advantage	$11.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.74
Rate for Payer: Cigna Commercial	$19.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.46
Rate for Payer: Oxford Commercial	$7.64
Rate for Payer: Qualcare PPO/HMO/WC	$5.73
Rate for Payer: UnitedHealthcare Commercial	$7.64
Rate for Payer: UnitedHealthcare Community & State	$0.92
Rate for Payer: Wellpoint Medicaid Managed Care	$1.01

TUBE ORAL RAE CUFFED 4.5MM

Facility

$23.58

Hospital Charge Code	270655757
Hospital Revenue Code	272
Min. Negotiated Rate	$3.54
Max. Negotiated Rate	$3.54
Rate for Payer: Qualcare PPO/HMO/WC	$3.54

TUBE ORAL RAE CUFFED 4.5MM

Facility

$23.58

Hospital Charge Code	270655757
Hospital Revenue Code	272
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$11.79
Rate for Payer: Aetna Commercial	$8.96
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	$11.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.07
Rate for Payer: Oxford Commercial	$4.72
Rate for Payer: Qualcare PPO/HMO/WC	$3.54
Rate for Payer: UnitedHealthcare Commercial	$4.72
Rate for Payer: UnitedHealthcare Community & State	$0.57
Rate for Payer: Wellpoint Medicaid Managed Care	$0.62

TUBE ORAL RAE CUFFED 4.5MM

Facility

$187.45

Hospital Charge Code	270656299
Hospital Revenue Code	271
Min. Negotiated Rate	$4.52
Max. Negotiated Rate	$93.72
Rate for Payer: Aetna Commercial	$71.23
Rate for Payer: Aetna Medicare Advantage	$56.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.80
Rate for Payer: Cigna Commercial	$93.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.23
Rate for Payer: Oxford Commercial	$37.49
Rate for Payer: Qualcare PPO/HMO/WC	$28.12
Rate for Payer: UnitedHealthcare Commercial	$37.49
Rate for Payer: UnitedHealthcare Community & State	$4.52
Rate for Payer: Wellpoint Medicaid Managed Care	$4.97

TUBE ORAL RAE CUFFED 4.5MM

Facility

$187.45

Hospital Charge Code	270656299
Hospital Revenue Code	271
Min. Negotiated Rate	$28.12
Max. Negotiated Rate	$28.12
Rate for Payer: Qualcare PPO/HMO/WC	$28.12

TUBE ORAL RAE CUFFED 5.0MM

Facility

$374.90

Hospital Charge Code	270655752
Hospital Revenue Code	271
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$187.45
Rate for Payer: Aetna Commercial	$142.46
Rate for Payer: Aetna Medicare Advantage	$112.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.60
Rate for Payer: Cigna Commercial	$187.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.47
Rate for Payer: Oxford Commercial	$74.98
Rate for Payer: Qualcare PPO/HMO/WC	$56.23
Rate for Payer: UnitedHealthcare Commercial	$74.98
Rate for Payer: UnitedHealthcare Community & State	$9.04
Rate for Payer: Wellpoint Medicaid Managed Care	$9.93

TUBE ORAL RAE CUFFED 5.0MM

Facility

$23.58

Hospital Charge Code	270660320
Hospital Revenue Code	272
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$11.79
Rate for Payer: Aetna Commercial	$8.96
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	$11.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.07
Rate for Payer: Oxford Commercial	$4.72
Rate for Payer: Qualcare PPO/HMO/WC	$3.54
Rate for Payer: UnitedHealthcare Commercial	$4.72
Rate for Payer: UnitedHealthcare Community & State	$0.57
Rate for Payer: Wellpoint Medicaid Managed Care	$0.62

TUBE ORAL RAE CUFFED 5.0MM

Facility

$23.58

Hospital Charge Code	270660320
Hospital Revenue Code	272
Min. Negotiated Rate	$3.54
Max. Negotiated Rate	$3.54
Rate for Payer: Qualcare PPO/HMO/WC	$3.54

TUBE ORAL RAE CUFFED 5.0MM

Facility

$374.90

Hospital Charge Code	270655752
Hospital Revenue Code	271
Min. Negotiated Rate	$56.23
Max. Negotiated Rate	$56.23
Rate for Payer: Qualcare PPO/HMO/WC	$56.23

TUBE ORAL RAE CUFFED 5.5MM

Facility

$23.58

Hospital Charge Code	270660321
Hospital Revenue Code	272
Min. Negotiated Rate	$3.54
Max. Negotiated Rate	$3.54
Rate for Payer: Qualcare PPO/HMO/WC	$3.54

TUBE ORAL RAE CUFFED 5.5MM

Facility

$23.58

Hospital Charge Code	270660321
Hospital Revenue Code	272
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$11.79
Rate for Payer: Aetna Commercial	$8.96
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	$11.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.07
Rate for Payer: Oxford Commercial	$4.72
Rate for Payer: Qualcare PPO/HMO/WC	$3.54
Rate for Payer: UnitedHealthcare Commercial	$4.72
Rate for Payer: UnitedHealthcare Community & State	$0.57
Rate for Payer: Wellpoint Medicaid Managed Care	$0.62

TUBE ORAL RAE ENDOTRACH 5.5

Facility

$374.90

Hospital Charge Code	270656038
Hospital Revenue Code	271
Min. Negotiated Rate	$56.23
Max. Negotiated Rate	$56.23
Rate for Payer: Qualcare PPO/HMO/WC	$56.23

TUBE ORAL RAE ENDOTRACH 5.5

Facility

$374.90

Hospital Charge Code	270656038
Hospital Revenue Code	271
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$187.45
Rate for Payer: Aetna Commercial	$142.46
Rate for Payer: Aetna Medicare Advantage	$112.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.60
Rate for Payer: Cigna Commercial	$187.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.47
Rate for Payer: Oxford Commercial	$74.98
Rate for Payer: Qualcare PPO/HMO/WC	$56.23
Rate for Payer: UnitedHealthcare Commercial	$74.98
Rate for Payer: UnitedHealthcare Community & State	$9.04
Rate for Payer: Wellpoint Medicaid Managed Care	$9.93

TUBE ORAL RAY ENDOTRACH 4

Facility

$374.90

Hospital Charge Code	270656041
Hospital Revenue Code	271
Min. Negotiated Rate	$56.23
Max. Negotiated Rate	$56.23
Rate for Payer: Qualcare PPO/HMO/WC	$56.23

TUBE ORAL RAY ENDOTRACH 4

Facility

$374.90

Hospital Charge Code	270656041
Hospital Revenue Code	271
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$187.45
Rate for Payer: Aetna Commercial	$142.46
Rate for Payer: Aetna Medicare Advantage	$112.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.60
Rate for Payer: Cigna Commercial	$187.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.47
Rate for Payer: Oxford Commercial	$74.98
Rate for Payer: Qualcare PPO/HMO/WC	$56.23
Rate for Payer: UnitedHealthcare Commercial	$74.98
Rate for Payer: UnitedHealthcare Community & State	$9.04
Rate for Payer: Wellpoint Medicaid Managed Care	$9.93

TUBE PAD NG SEALING 452040

Facility

$3.60

Hospital Charge Code	270641266
Hospital Revenue Code	270
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$0.54
Rate for Payer: Qualcare PPO/HMO/WC	$0.54

TUBE PAD NG SEALING 452040

Facility

$3.60

Hospital Charge Code	270641266
Hospital Revenue Code	270
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$1.80
Rate for Payer: Aetna Commercial	$1.37
Rate for Payer: Aetna Medicare Advantage	$1.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.92
Rate for Payer: Cigna Commercial	$1.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.08
Rate for Payer: Oxford Commercial	$0.72
Rate for Payer: Qualcare PPO/HMO/WC	$0.54
Rate for Payer: UnitedHealthcare Commercial	$0.72
Rate for Payer: UnitedHealthcare Community & State	$0.09
Rate for Payer: Wellpoint Medicaid Managed Care	$0.10

TUBE PHYCON UNIVENT 7.0

Facility

$700.00

Hospital Charge Code	270618607
Hospital Revenue Code	271
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

Know your out-of-pocket cost for care.

All Charges