Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TUBE TRACH CUFFL FENES #4-8***

Facility

$219.00

Hospital Charge Code	8004319
Hospital Revenue Code	274
Min. Negotiated Rate	$32.85
Max. Negotiated Rate	$53.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$48.18
Rate for Payer: Qualcare PPO/HMO/WC	$32.85

TUBE TRACH CUFFL NONFN #4-8***

Facility

$180.00

Hospital Charge Code	8004335
Hospital Revenue Code	274
Min. Negotiated Rate	$27.00
Max. Negotiated Rate	$43.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$39.60
Rate for Payer: Qualcare PPO/HMO/WC	$27.00

TUBE TRACH CUFFL NONFN #4-8***

Facility

$180.00

Hospital Charge Code	8004335
Hospital Revenue Code	274
Min. Negotiated Rate	$4.34
Max. Negotiated Rate	$90.00
Rate for Payer: Aetna Commercial	$68.40
Rate for Payer: Aetna Medicare Advantage	$54.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.90
Rate for Payer: Cigna Commercial	$90.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$39.60
Rate for Payer: Qualcare PPO/HMO/WC	$27.00
Rate for Payer: UnitedHealthcare Community & State	$4.34
Rate for Payer: Wellpoint Medicaid Managed Care	$4.77

TUBE TRACH CUFF SZ 4 4DCT

Facility

$232.05

Hospital Charge Code	270649306
Hospital Revenue Code	272
Min. Negotiated Rate	$34.81
Max. Negotiated Rate	$34.81
Rate for Payer: Qualcare PPO/HMO/WC	$34.81

TUBE TRACH CUFF SZ 4 4DCT

Facility

$232.05

Hospital Charge Code	270649306
Hospital Revenue Code	272
Min. Negotiated Rate	$5.59
Max. Negotiated Rate	$116.03
Rate for Payer: Aetna Commercial	$88.18
Rate for Payer: Aetna Medicare Advantage	$69.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.17
Rate for Payer: Cigna Commercial	$116.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.61
Rate for Payer: Oxford Commercial	$46.41
Rate for Payer: Qualcare PPO/HMO/WC	$34.81
Rate for Payer: UnitedHealthcare Commercial	$46.41
Rate for Payer: UnitedHealthcare Community & State	$5.59
Rate for Payer: Wellpoint Medicaid Managed Care	$6.15

TUBE TRACH CUF XL 6.0 72120060

Facility

$267.90

Hospital Charge Code	270633234
Hospital Revenue Code	272
Min. Negotiated Rate	$6.46
Max. Negotiated Rate	$133.95
Rate for Payer: Aetna Commercial	$101.80
Rate for Payer: Aetna Medicare Advantage	$80.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.31
Rate for Payer: Cigna Commercial	$133.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.37
Rate for Payer: Oxford Commercial	$53.58
Rate for Payer: Qualcare PPO/HMO/WC	$40.19
Rate for Payer: UnitedHealthcare Commercial	$53.58
Rate for Payer: UnitedHealthcare Community & State	$6.46
Rate for Payer: Wellpoint Medicaid Managed Care	$7.10

TUBE TRACH CUF XL 6.0 72120060

Facility

$267.90

Hospital Charge Code	270633234
Hospital Revenue Code	272
Min. Negotiated Rate	$40.19
Max. Negotiated Rate	$40.19
Rate for Payer: Qualcare PPO/HMO/WC	$40.19

TUBE TRACH CUS HA05CS80NNC228N

Facility

$1,314.45

Hospital Charge Code	270634786
Hospital Revenue Code	272
Min. Negotiated Rate	$197.17
Max. Negotiated Rate	$197.17
Rate for Payer: Qualcare PPO/HMO/WC	$197.17

TUBE TRACH CUS HA05CS80NNC228N

Facility

$1,314.45

Hospital Charge Code	270634786
Hospital Revenue Code	272
Min. Negotiated Rate	$31.68
Max. Negotiated Rate	$657.23
Rate for Payer: Aetna Commercial	$499.49
Rate for Payer: Aetna Medicare Advantage	$394.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$335.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$335.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$335.18
Rate for Payer: Cigna Commercial	$657.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$394.33
Rate for Payer: Oxford Commercial	$262.89
Rate for Payer: Qualcare PPO/HMO/WC	$197.17
Rate for Payer: UnitedHealthcare Commercial	$262.89
Rate for Payer: UnitedHealthcare Community & State	$31.68
Rate for Payer: Wellpoint Medicaid Managed Care	$34.83

TUBE TRACHEAL 7.5 CUFFED Q

Facility

$522.00

Hospital Charge Code	270660792
Hospital Revenue Code	270
Min. Negotiated Rate	$78.30
Max. Negotiated Rate	$78.30
Rate for Payer: Qualcare PPO/HMO/WC	$78.30

TUBE TRACHEAL 7.5 CUFFED Q

Facility

$522.00

Hospital Charge Code	270660792
Hospital Revenue Code	270
Min. Negotiated Rate	$12.58
Max. Negotiated Rate	$261.00
Rate for Payer: Aetna Commercial	$198.36
Rate for Payer: Aetna Medicare Advantage	$156.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.11
Rate for Payer: Cigna Commercial	$261.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.60
Rate for Payer: Oxford Commercial	$104.40
Rate for Payer: Qualcare PPO/HMO/WC	$78.30
Rate for Payer: UnitedHealthcare Commercial	$104.40
Rate for Payer: UnitedHealthcare Community & State	$12.58
Rate for Payer: Wellpoint Medicaid Managed Care	$13.83

TUBE TRACHEAL MURPHY 6.0

Facility

$104.00

Hospital Charge Code	270666938
Hospital Revenue Code	270
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$15.60
Rate for Payer: Qualcare PPO/HMO/WC	$15.60

TUBE TRACHEAL MURPHY 6.0

Facility

$104.00

Hospital Charge Code	270666938
Hospital Revenue Code	270
Min. Negotiated Rate	$2.51
Max. Negotiated Rate	$52.00
Rate for Payer: Aetna Commercial	$39.52
Rate for Payer: Aetna Medicare Advantage	$31.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.52
Rate for Payer: Cigna Commercial	$52.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.20
Rate for Payer: Oxford Commercial	$20.80
Rate for Payer: Qualcare PPO/HMO/WC	$15.60
Rate for Payer: UnitedHealthcare Commercial	$20.80
Rate for Payer: UnitedHealthcare Community & State	$2.51
Rate for Payer: Wellpoint Medicaid Managed Care	$2.76

TUBE TRACHEAL MURPHY 6.5

Facility

$104.00

Hospital Charge Code	270666939
Hospital Revenue Code	270
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$15.60
Rate for Payer: Qualcare PPO/HMO/WC	$15.60

TUBE TRACHEAL MURPHY 6.5

Facility

$104.00

Hospital Charge Code	270666939
Hospital Revenue Code	270
Min. Negotiated Rate	$2.51
Max. Negotiated Rate	$52.00
Rate for Payer: Aetna Commercial	$39.52
Rate for Payer: Aetna Medicare Advantage	$31.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.52
Rate for Payer: Cigna Commercial	$52.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.20
Rate for Payer: Oxford Commercial	$20.80
Rate for Payer: Qualcare PPO/HMO/WC	$15.60
Rate for Payer: UnitedHealthcare Commercial	$20.80
Rate for Payer: UnitedHealthcare Community & State	$2.51
Rate for Payer: Wellpoint Medicaid Managed Care	$2.76

TUBE TRACHEOSTOMY #10

Facility

$229.85

Hospital Charge Code	270650076
Hospital Revenue Code	270
Min. Negotiated Rate	$34.48
Max. Negotiated Rate	$34.48
Rate for Payer: Qualcare PPO/HMO/WC	$34.48

TUBE TRACHEOSTOMY #10

Facility

$229.85

Hospital Charge Code	270650076
Hospital Revenue Code	270
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$114.92
Rate for Payer: Aetna Commercial	$87.34
Rate for Payer: Aetna Medicare Advantage	$68.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.61
Rate for Payer: Cigna Commercial	$114.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.95
Rate for Payer: Oxford Commercial	$45.97
Rate for Payer: Qualcare PPO/HMO/WC	$34.48
Rate for Payer: UnitedHealthcare Commercial	$45.97
Rate for Payer: UnitedHealthcare Community & State	$5.54
Rate for Payer: Wellpoint Medicaid Managed Care	$6.09

TUBE TRACH FENESTRATED SZ10

Facility

$210.15

Hospital Charge Code	270649902
Hospital Revenue Code	270
Min. Negotiated Rate	$5.06
Max. Negotiated Rate	$105.08
Rate for Payer: Aetna Commercial	$79.86
Rate for Payer: Aetna Medicare Advantage	$63.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.59
Rate for Payer: Cigna Commercial	$105.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.05
Rate for Payer: Oxford Commercial	$42.03
Rate for Payer: Qualcare PPO/HMO/WC	$31.52
Rate for Payer: UnitedHealthcare Commercial	$42.03
Rate for Payer: UnitedHealthcare Community & State	$5.06
Rate for Payer: Wellpoint Medicaid Managed Care	$5.57

TUBE TRACH FENESTRATED SZ10

Facility

$210.15

Hospital Charge Code	270649902
Hospital Revenue Code	270
Min. Negotiated Rate	$31.52
Max. Negotiated Rate	$31.52
Rate for Payer: Qualcare PPO/HMO/WC	$31.52

TUBE TRACH FENESTRATED SZ8

Facility

$207.15

Hospital Charge Code	270649904
Hospital Revenue Code	272
Min. Negotiated Rate	$4.99
Max. Negotiated Rate	$103.58
Rate for Payer: Aetna Commercial	$78.72
Rate for Payer: Aetna Medicare Advantage	$62.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.82
Rate for Payer: Cigna Commercial	$103.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.15
Rate for Payer: Oxford Commercial	$41.43
Rate for Payer: Qualcare PPO/HMO/WC	$31.07
Rate for Payer: UnitedHealthcare Commercial	$41.43
Rate for Payer: UnitedHealthcare Community & State	$4.99
Rate for Payer: Wellpoint Medicaid Managed Care	$5.49

TUBE TRACH FENESTRATED SZ8

Facility

$207.15

Hospital Charge Code	270649904
Hospital Revenue Code	272
Min. Negotiated Rate	$31.07
Max. Negotiated Rate	$31.07
Rate for Payer: Qualcare PPO/HMO/WC	$31.07

TUBE TRACH FENEST SZ 4

Facility

$604.00

Hospital Charge Code	270302410
Hospital Revenue Code	272
Min. Negotiated Rate	$14.56
Max. Negotiated Rate	$302.00
Rate for Payer: Aetna Commercial	$229.52
Rate for Payer: Aetna Medicare Advantage	$181.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$154.02
Rate for Payer: Cigna Commercial	$302.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.20
Rate for Payer: Oxford Commercial	$120.80
Rate for Payer: Qualcare PPO/HMO/WC	$90.60
Rate for Payer: UnitedHealthcare Commercial	$120.80
Rate for Payer: UnitedHealthcare Community & State	$14.56
Rate for Payer: Wellpoint Medicaid Managed Care	$16.01

TUBE TRACH FENEST SZ 4

Facility

$604.00

Hospital Charge Code	270302410
Hospital Revenue Code	272
Min. Negotiated Rate	$90.60
Max. Negotiated Rate	$90.60
Rate for Payer: Qualcare PPO/HMO/WC	$90.60

TUBE TRACH FENEST SZ 6

Facility

$604.00

Hospital Charge Code	270302415
Hospital Revenue Code	270
Min. Negotiated Rate	$90.60
Max. Negotiated Rate	$90.60
Rate for Payer: Qualcare PPO/HMO/WC	$90.60

TUBE TRACH FENEST SZ 6

Facility

$604.00

Hospital Charge Code	270302415
Hospital Revenue Code	270
Min. Negotiated Rate	$14.56
Max. Negotiated Rate	$302.00
Rate for Payer: Aetna Commercial	$229.52
Rate for Payer: Aetna Medicare Advantage	$181.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$154.02
Rate for Payer: Cigna Commercial	$302.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.20
Rate for Payer: Oxford Commercial	$120.80
Rate for Payer: Qualcare PPO/HMO/WC	$90.60
Rate for Payer: UnitedHealthcare Commercial	$120.80
Rate for Payer: UnitedHealthcare Community & State	$14.56
Rate for Payer: Wellpoint Medicaid Managed Care	$16.01

Know your out-of-pocket cost for care.

All Charges