Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TUBE T DEAVER 12FR

Facility

$92.00

Hospital Charge Code	270617091
Hospital Revenue Code	272
Min. Negotiated Rate	$2.22
Max. Negotiated Rate	$46.00
Rate for Payer: Aetna Commercial	$34.96
Rate for Payer: Aetna Medicare Advantage	$27.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.46
Rate for Payer: Cigna Commercial	$46.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.60
Rate for Payer: Oxford Commercial	$18.40
Rate for Payer: Qualcare PPO/HMO/WC	$13.80
Rate for Payer: UnitedHealthcare Commercial	$18.40
Rate for Payer: UnitedHealthcare Community & State	$2.22
Rate for Payer: Wellpoint Medicaid Managed Care	$2.44

TUBE T DEAVER 12FR

Facility

$92.00

Hospital Charge Code	270617091
Hospital Revenue Code	272
Min. Negotiated Rate	$13.80
Max. Negotiated Rate	$13.80
Rate for Payer: Qualcare PPO/HMO/WC	$13.80

TUBE T DEAVER 5FR PED

Facility

$242.45

Hospital Charge Code	270606961
Hospital Revenue Code	272
Min. Negotiated Rate	$5.84
Max. Negotiated Rate	$121.22
Rate for Payer: Aetna Commercial	$92.13
Rate for Payer: Aetna Medicare Advantage	$72.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.82
Rate for Payer: Cigna Commercial	$121.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.73
Rate for Payer: Oxford Commercial	$48.49
Rate for Payer: Qualcare PPO/HMO/WC	$36.37
Rate for Payer: UnitedHealthcare Commercial	$48.49
Rate for Payer: UnitedHealthcare Community & State	$5.84
Rate for Payer: Wellpoint Medicaid Managed Care	$6.42

TUBE T DEAVER 5FR PED

Facility

$242.45

Hospital Charge Code	270606961
Hospital Revenue Code	272
Min. Negotiated Rate	$36.37
Max. Negotiated Rate	$36.37
Rate for Payer: Qualcare PPO/HMO/WC	$36.37

TUBE T DEAVER 8FR

Facility

$123.25

Hospital Charge Code	270606962
Hospital Revenue Code	272
Min. Negotiated Rate	$18.49
Max. Negotiated Rate	$18.49
Rate for Payer: Qualcare PPO/HMO/WC	$18.49

TUBE T DEAVER 8FR

Facility

$123.25

Hospital Charge Code	270606962
Hospital Revenue Code	272
Min. Negotiated Rate	$2.97
Max. Negotiated Rate	$61.62
Rate for Payer: Aetna Commercial	$46.84
Rate for Payer: Aetna Medicare Advantage	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.43
Rate for Payer: Cigna Commercial	$61.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.98
Rate for Payer: Oxford Commercial	$24.65
Rate for Payer: Qualcare PPO/HMO/WC	$18.49
Rate for Payer: UnitedHealthcare Commercial	$24.65
Rate for Payer: UnitedHealthcare Community & State	$2.97
Rate for Payer: Wellpoint Medicaid Managed Care	$3.27

TUBE T DRAIN 12FR*****

Facility

$42.48

Hospital Charge Code	270061530
Hospital Revenue Code	272
Min. Negotiated Rate	$6.37
Max. Negotiated Rate	$6.37
Rate for Payer: Qualcare PPO/HMO/WC	$6.37

TUBE T DRAIN 12FR*****

Facility

$42.48

Hospital Charge Code	270061530
Hospital Revenue Code	272
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$21.24
Rate for Payer: Aetna Commercial	$16.14
Rate for Payer: Aetna Medicare Advantage	$12.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.83
Rate for Payer: Cigna Commercial	$21.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.74
Rate for Payer: Oxford Commercial	$8.50
Rate for Payer: Qualcare PPO/HMO/WC	$6.37
Rate for Payer: UnitedHealthcare Commercial	$8.50
Rate for Payer: UnitedHealthcare Community & State	$1.02
Rate for Payer: Wellpoint Medicaid Managed Care	$1.13

TUBE T DRAIN 14F 06200099820

Facility

$37.20

Hospital Charge Code	270617092
Hospital Revenue Code	272
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$18.60
Rate for Payer: Aetna Commercial	$14.14
Rate for Payer: Aetna Medicare Advantage	$11.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.49
Rate for Payer: Cigna Commercial	$18.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.16
Rate for Payer: Oxford Commercial	$7.44
Rate for Payer: Qualcare PPO/HMO/WC	$5.58
Rate for Payer: UnitedHealthcare Commercial	$7.44
Rate for Payer: UnitedHealthcare Community & State	$0.90
Rate for Payer: Wellpoint Medicaid Managed Care	$0.99

TUBE T DRAIN 14F 06200099820

Facility

$37.20

Hospital Charge Code	270617092
Hospital Revenue Code	272
Min. Negotiated Rate	$5.58
Max. Negotiated Rate	$5.58
Rate for Payer: Qualcare PPO/HMO/WC	$5.58

TUBE T DRAIN 14FR

Facility

$110.45

Hospital Charge Code	270061535
Hospital Revenue Code	272
Min. Negotiated Rate	$16.57
Max. Negotiated Rate	$16.57
Rate for Payer: Qualcare PPO/HMO/WC	$16.57

TUBE T DRAIN 14FR

Facility

$110.45

Hospital Charge Code	270061535
Hospital Revenue Code	272
Min. Negotiated Rate	$2.66
Max. Negotiated Rate	$55.23
Rate for Payer: Aetna Commercial	$41.97
Rate for Payer: Aetna Medicare Advantage	$33.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.16
Rate for Payer: Cigna Commercial	$55.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.13
Rate for Payer: Oxford Commercial	$22.09
Rate for Payer: Qualcare PPO/HMO/WC	$16.57
Rate for Payer: UnitedHealthcare Commercial	$22.09
Rate for Payer: UnitedHealthcare Community & State	$2.66
Rate for Payer: Wellpoint Medicaid Managed Care	$2.93

TUBE T DRAIN 16FR

Facility

$116.85

Hospital Charge Code	270061540
Hospital Revenue Code	272
Min. Negotiated Rate	$17.53
Max. Negotiated Rate	$17.53
Rate for Payer: Qualcare PPO/HMO/WC	$17.53

TUBE T DRAIN 16FR

Facility

$116.85

Hospital Charge Code	270061540
Hospital Revenue Code	272
Min. Negotiated Rate	$2.82
Max. Negotiated Rate	$58.42
Rate for Payer: Aetna Commercial	$44.40
Rate for Payer: Aetna Medicare Advantage	$35.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.80
Rate for Payer: Cigna Commercial	$58.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.05
Rate for Payer: Oxford Commercial	$23.37
Rate for Payer: Qualcare PPO/HMO/WC	$17.53
Rate for Payer: UnitedHealthcare Commercial	$23.37
Rate for Payer: UnitedHealthcare Community & State	$2.82
Rate for Payer: Wellpoint Medicaid Managed Care	$3.10

TUBE T DRAIN 16FR 06200099830

Facility

$37.95

Hospital Charge Code	270617093
Hospital Revenue Code	272
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$18.98
Rate for Payer: Aetna Commercial	$14.42
Rate for Payer: Aetna Medicare Advantage	$11.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.68
Rate for Payer: Cigna Commercial	$18.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.38
Rate for Payer: Oxford Commercial	$7.59
Rate for Payer: Qualcare PPO/HMO/WC	$5.69
Rate for Payer: UnitedHealthcare Commercial	$7.59
Rate for Payer: UnitedHealthcare Community & State	$0.91
Rate for Payer: Wellpoint Medicaid Managed Care	$1.01

TUBE T DRAIN 16FR 06200099830

Facility

$37.95

Hospital Charge Code	270617093
Hospital Revenue Code	272
Min. Negotiated Rate	$5.69
Max. Negotiated Rate	$5.69
Rate for Payer: Qualcare PPO/HMO/WC	$5.69

TUBE TEFLON

Facility

$1,404.05

Hospital Charge Code	270661243
Hospital Revenue Code	272
Min. Negotiated Rate	$210.61
Max. Negotiated Rate	$210.61
Rate for Payer: Qualcare PPO/HMO/WC	$210.61

TUBE TEFLON

Facility

$1,404.05

Hospital Charge Code	270661243
Hospital Revenue Code	272
Min. Negotiated Rate	$33.84
Max. Negotiated Rate	$702.02
Rate for Payer: Aetna Commercial	$533.54
Rate for Payer: Aetna Medicare Advantage	$421.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$358.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$358.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$358.03
Rate for Payer: Cigna Commercial	$702.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$421.21
Rate for Payer: Oxford Commercial	$280.81
Rate for Payer: Qualcare PPO/HMO/WC	$210.61
Rate for Payer: UnitedHealthcare Commercial	$280.81
Rate for Payer: UnitedHealthcare Community & State	$33.84
Rate for Payer: Wellpoint Medicaid Managed Care	$37.21

TUBE TRACH ******

Facility

$118.00

Hospital Charge Code	8001737
Hospital Revenue Code	279
Min. Negotiated Rate	$17.70
Max. Negotiated Rate	$17.70
Rate for Payer: Qualcare PPO/HMO/WC	$17.70

TUBE TRACH ******

Facility

$118.00

Hospital Charge Code	8001737
Hospital Revenue Code	279
Min. Negotiated Rate	$2.84
Max. Negotiated Rate	$59.00
Rate for Payer: Aetna Commercial	$44.84
Rate for Payer: Aetna Medicare Advantage	$35.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.09
Rate for Payer: Cigna Commercial	$59.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.40
Rate for Payer: Oxford Commercial	$23.60
Rate for Payer: Qualcare PPO/HMO/WC	$17.70
Rate for Payer: UnitedHealthcare Commercial	$23.60
Rate for Payer: UnitedHealthcare Community & State	$2.84
Rate for Payer: Wellpoint Medicaid Managed Care	$3.13

TUBE TRACH 14FR

Facility

$117.00

Service Code	HCPCS A4622
Hospital Charge Code	270600661
Hospital Revenue Code	274
Min. Negotiated Rate	$2.82
Max. Negotiated Rate	$58.50
Rate for Payer: Aetna Commercial	$44.46
Rate for Payer: Aetna Medicare Advantage	$35.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.84
Rate for Payer: Cigna Commercial	$58.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$25.74
Rate for Payer: Qualcare PPO/HMO/WC	$17.55
Rate for Payer: UnitedHealthcare Community & State	$2.82
Rate for Payer: Wellpoint Medicaid Managed Care	$3.10

TUBE TRACH 14FR

Facility

$117.00

Service Code	HCPCS A4622
Hospital Charge Code	270600661
Hospital Revenue Code	274
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$28.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$25.74
Rate for Payer: Qualcare PPO/HMO/WC	$17.55

TUBE TRACH 6.0mm XLT UNCUFFED

Facility

$319.30

Hospital Charge Code	270643229
Hospital Revenue Code	272
Min. Negotiated Rate	$47.90
Max. Negotiated Rate	$47.90
Rate for Payer: Qualcare PPO/HMO/WC	$47.90

TUBE TRACH 6.0mm XLT UNCUFFED

Facility

$319.30

Hospital Charge Code	270643229
Hospital Revenue Code	272
Min. Negotiated Rate	$7.70
Max. Negotiated Rate	$159.65
Rate for Payer: Aetna Commercial	$121.33
Rate for Payer: Aetna Medicare Advantage	$95.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.42
Rate for Payer: Cigna Commercial	$159.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.79
Rate for Payer: Oxford Commercial	$63.86
Rate for Payer: Qualcare PPO/HMO/WC	$47.90
Rate for Payer: UnitedHealthcare Commercial	$63.86
Rate for Payer: UnitedHealthcare Community & State	$7.70
Rate for Payer: Wellpoint Medicaid Managed Care	$8.46

TUBE TRACH #6DCT

Facility

$194.55

Hospital Charge Code	270649905
Hospital Revenue Code	272
Min. Negotiated Rate	$4.69
Max. Negotiated Rate	$97.28
Rate for Payer: Aetna Commercial	$73.93
Rate for Payer: Aetna Medicare Advantage	$58.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.61
Rate for Payer: Cigna Commercial	$97.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.37
Rate for Payer: Oxford Commercial	$38.91
Rate for Payer: Qualcare PPO/HMO/WC	$29.18
Rate for Payer: UnitedHealthcare Commercial	$38.91
Rate for Payer: UnitedHealthcare Community & State	$4.69
Rate for Payer: Wellpoint Medicaid Managed Care	$5.16

Know your out-of-pocket cost for care.

All Charges