Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TUBE PHYCON UNIVENT 7.0

Facility

$700.00

Hospital Charge Code	270618607
Hospital Revenue Code	271
Min. Negotiated Rate	$16.87
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$210.00
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Commercial	$140.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$18.55

TUBE PHYCON UNIVNT 7.5 1202531

Facility

$996.85

Hospital Charge Code	270617224
Hospital Revenue Code	272
Min. Negotiated Rate	$149.53
Max. Negotiated Rate	$149.53
Rate for Payer: Qualcare PPO/HMO/WC	$149.53

TUBE PHYCON UNIVNT 7.5 1202531

Facility

$996.85

Hospital Charge Code	270617224
Hospital Revenue Code	272
Min. Negotiated Rate	$24.02
Max. Negotiated Rate	$498.43
Rate for Payer: Aetna Commercial	$378.80
Rate for Payer: Aetna Medicare Advantage	$299.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$254.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$254.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$254.20
Rate for Payer: Cigna Commercial	$498.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$299.06
Rate for Payer: Oxford Commercial	$199.37
Rate for Payer: Qualcare PPO/HMO/WC	$149.53
Rate for Payer: UnitedHealthcare Commercial	$199.37
Rate for Payer: UnitedHealthcare Community & State	$24.02
Rate for Payer: Wellpoint Medicaid Managed Care	$26.42

TUBE PHYCON UNIVNT 8.0 1202633

Facility

$694.45

Hospital Charge Code	270617225
Hospital Revenue Code	272
Min. Negotiated Rate	$104.17
Max. Negotiated Rate	$104.17
Rate for Payer: Qualcare PPO/HMO/WC	$104.17

TUBE PHYCON UNIVNT 8.0 1202633

Facility

$694.45

Hospital Charge Code	270617225
Hospital Revenue Code	272
Min. Negotiated Rate	$16.74
Max. Negotiated Rate	$347.23
Rate for Payer: Aetna Commercial	$263.89
Rate for Payer: Aetna Medicare Advantage	$208.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.08
Rate for Payer: Cigna Commercial	$347.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.34
Rate for Payer: Oxford Commercial	$138.89
Rate for Payer: Qualcare PPO/HMO/WC	$104.17
Rate for Payer: UnitedHealthcare Commercial	$138.89
Rate for Payer: UnitedHealthcare Community & State	$16.74
Rate for Payer: Wellpoint Medicaid Managed Care	$18.40

TUBE PHYCON UNVENT 8.5 1202635

Facility

$69.50

Hospital Charge Code	270618446
Hospital Revenue Code	272
Min. Negotiated Rate	$1.67
Max. Negotiated Rate	$34.75
Rate for Payer: Aetna Commercial	$26.41
Rate for Payer: Aetna Medicare Advantage	$20.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.72
Rate for Payer: Cigna Commercial	$34.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.85
Rate for Payer: Oxford Commercial	$13.90
Rate for Payer: Qualcare PPO/HMO/WC	$10.43
Rate for Payer: UnitedHealthcare Commercial	$13.90
Rate for Payer: UnitedHealthcare Community & State	$1.67
Rate for Payer: Wellpoint Medicaid Managed Care	$1.84

TUBE PHYCON UNVENT 8.5 1202635

Facility

$69.50

Hospital Charge Code	270618446
Hospital Revenue Code	272
Min. Negotiated Rate	$10.43
Max. Negotiated Rate	$10.43
Rate for Payer: Qualcare PPO/HMO/WC	$10.43

TUBE POLY W/SCRW CAP14-959-38C

Facility

$0.75

Hospital Charge Code	270635401
Hospital Revenue Code	272
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.38
Rate for Payer: Aetna Commercial	$0.29
Rate for Payer: Aetna Medicare Advantage	$0.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.19
Rate for Payer: Cigna Commercial	$0.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.23
Rate for Payer: Oxford Commercial	$0.15
Rate for Payer: Qualcare PPO/HMO/WC	$0.11
Rate for Payer: UnitedHealthcare Commercial	$0.15
Rate for Payer: UnitedHealthcare Community & State	$0.02
Rate for Payer: Wellpoint Medicaid Managed Care	$0.02

TUBE POLY W/SCRW CAP14-959-38C

Facility

$0.75

Hospital Charge Code	270635401
Hospital Revenue Code	272
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.11
Rate for Payer: Qualcare PPO/HMO/WC	$0.11

TUBE QUICK CHEST TRAY 12 FR

Facility

$713.00

Hospital Charge Code	270667392
Hospital Revenue Code	272
Min. Negotiated Rate	$17.18
Max. Negotiated Rate	$356.50
Rate for Payer: Aetna Commercial	$270.94
Rate for Payer: Aetna Medicare Advantage	$213.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$181.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$181.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$181.81
Rate for Payer: Cigna Commercial	$356.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.90
Rate for Payer: Oxford Commercial	$142.60
Rate for Payer: Qualcare PPO/HMO/WC	$106.95
Rate for Payer: UnitedHealthcare Commercial	$142.60
Rate for Payer: UnitedHealthcare Community & State	$17.18
Rate for Payer: Wellpoint Medicaid Managed Care	$18.89

TUBE QUICK CHEST TRAY 12 FR

Facility

$713.00

Hospital Charge Code	270667392
Hospital Revenue Code	272
Min. Negotiated Rate	$106.95
Max. Negotiated Rate	$106.95
Rate for Payer: Qualcare PPO/HMO/WC	$106.95

TUBERCULIN 5 UNITS/0.1 ML INJ

Facility

$377.88

Service Code	NDC 49281075221
Hospital Charge Code	60627883
Hospital Revenue Code	250
Min. Negotiated Rate	$9.11
Max. Negotiated Rate	$188.94
Rate for Payer: Aetna Commercial	$143.59
Rate for Payer: Aetna Medicare Advantage	$113.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.36
Rate for Payer: Cigna Commercial	$188.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.36
Rate for Payer: Oxford Commercial	$75.58
Rate for Payer: Qualcare PPO/HMO/WC	$56.68
Rate for Payer: UnitedHealthcare Commercial	$75.58
Rate for Payer: UnitedHealthcare Community & State	$9.11
Rate for Payer: Wellpoint Medicaid Managed Care	$10.01

TUBERCULIN 5 UNITS/0.1 ML INJ

Facility

$377.88

Service Code	NDC 49281075221
Hospital Charge Code	60627883
Hospital Revenue Code	250
Min. Negotiated Rate	$56.68
Max. Negotiated Rate	$56.68
Rate for Payer: Qualcare PPO/HMO/WC	$56.68

TUBERCULIN INJ 1ML VIAL

Facility

$21.15

Hospital Charge Code	6009104
Hospital Revenue Code	250
Min. Negotiated Rate	$3.17
Max. Negotiated Rate	$3.17
Rate for Payer: Qualcare PPO/HMO/WC	$3.17

TUBERCULIN INJ 1ML VIAL

Facility

$21.15

Hospital Charge Code	6009104
Hospital Revenue Code	250
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$10.57
Rate for Payer: Aetna Commercial	$8.04
Rate for Payer: Aetna Medicare Advantage	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.39
Rate for Payer: Cigna Commercial	$10.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.34
Rate for Payer: Oxford Commercial	$4.23
Rate for Payer: Qualcare PPO/HMO/WC	$3.17
Rate for Payer: UnitedHealthcare Commercial	$4.23
Rate for Payer: UnitedHealthcare Community & State	$0.51
Rate for Payer: Wellpoint Medicaid Managed Care	$0.56

TUBERCULIN INJ 1TU/0.1ML 5ML

Facility

$1,375.24

Service Code	NDC 49281075222
Hospital Charge Code	60627882
Hospital Revenue Code	250
Min. Negotiated Rate	$33.14
Max. Negotiated Rate	$687.62
Rate for Payer: Aetna Commercial	$522.59
Rate for Payer: Aetna Medicare Advantage	$412.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$350.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$350.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$350.69
Rate for Payer: Cigna Commercial	$687.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$412.57
Rate for Payer: Oxford Commercial	$275.05
Rate for Payer: Qualcare PPO/HMO/WC	$206.29
Rate for Payer: UnitedHealthcare Commercial	$275.05
Rate for Payer: UnitedHealthcare Community & State	$33.14
Rate for Payer: Wellpoint Medicaid Managed Care	$36.44

TUBERCULIN INJ 1TU/0.1ML 5ML

Facility

$1,375.24

Service Code	NDC 49281075222
Hospital Charge Code	60627882
Hospital Revenue Code	250
Min. Negotiated Rate	$206.29
Max. Negotiated Rate	$206.29
Rate for Payer: Qualcare PPO/HMO/WC	$206.29

TUBERCULIN INJ 5ML

Facility

$43.55

Hospital Charge Code	6009112
Hospital Revenue Code	250
Min. Negotiated Rate	$6.53
Max. Negotiated Rate	$6.53
Rate for Payer: Qualcare PPO/HMO/WC	$6.53

TUBERCULIN INJ 5ML

Facility

$43.55

Hospital Charge Code	6009112
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$21.77
Rate for Payer: Aetna Commercial	$16.55
Rate for Payer: Aetna Medicare Advantage	$13.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.11
Rate for Payer: Cigna Commercial	$21.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.06
Rate for Payer: Oxford Commercial	$8.71
Rate for Payer: Qualcare PPO/HMO/WC	$6.53
Rate for Payer: UnitedHealthcare Commercial	$8.71
Rate for Payer: UnitedHealthcare Community & State	$1.05
Rate for Payer: Wellpoint Medicaid Managed Care	$1.15

TUBERCULIN SKIN TEST 5TU

Facility

$3.20

Hospital Charge Code	6022909
Hospital Revenue Code	250
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$1.60
Rate for Payer: Aetna Commercial	$1.22
Rate for Payer: Aetna Medicare Advantage	$0.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.82
Rate for Payer: Cigna Commercial	$1.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.96
Rate for Payer: Oxford Commercial	$0.64
Rate for Payer: Qualcare PPO/HMO/WC	$0.48
Rate for Payer: UnitedHealthcare Commercial	$0.64
Rate for Payer: UnitedHealthcare Community & State	$0.08
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

TUBERCULIN SKIN TEST 5TU

Facility

$3.20

Hospital Charge Code	6022909
Hospital Revenue Code	250
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$0.48
Rate for Payer: Qualcare PPO/HMO/WC	$0.48

TUBERCULOSIS PPD INTRDERM TEST

Facility

$390.00

Service Code	HCPCS 86580
Hospital Charge Code	9400185
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

TUBERCULOSIS PPD INTRDERM TEST

Facility

$390.00

Service Code	HCPCS 86580
Hospital Charge Code	9400185
Hospital Revenue Code	302
Min. Negotiated Rate	$7.74
Max. Negotiated Rate	$124.03
Rate for Payer: Aetna Commercial	$93.46
Rate for Payer: Aetna Medicare Advantage	$111.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$34.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.03
Rate for Payer: Cigna Commercial	$68.87
Rate for Payer: Cigna Medicare Advantage	$34.36
Rate for Payer: Clover Medicare Advantage	$32.64
Rate for Payer: EmblemHealth Commercial	$103.08
Rate for Payer: Humana Medicare Advantage	$35.39
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$34.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$8.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$34.36
Rate for Payer: Wellcare Medicare Advantage	$34.36
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

TUBE RECTAL 18FR

Facility

$4.45

Hospital Charge Code	270649940
Hospital Revenue Code	270
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$0.67
Rate for Payer: Qualcare PPO/HMO/WC	$0.67

TUBE RECTAL 18FR

Facility

$4.45

Hospital Charge Code	270649940
Hospital Revenue Code	270
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.23
Rate for Payer: Aetna Commercial	$1.69
Rate for Payer: Aetna Medicare Advantage	$1.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.13
Rate for Payer: Cigna Commercial	$2.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.33
Rate for Payer: Oxford Commercial	$0.89
Rate for Payer: Qualcare PPO/HMO/WC	$0.67
Rate for Payer: UnitedHealthcare Commercial	$0.89
Rate for Payer: UnitedHealthcare Community & State	$0.11
Rate for Payer: Wellpoint Medicaid Managed Care	$0.12

Know your out-of-pocket cost for care.

All Charges